What Is The Ideal Answer To Heel Spur

Posterior Calcaneal Spur


Overview


Heel spurs refer to the abnormal accumulation of calcium deposits on the heel of the foot. Vigorous, repetitive movements often result in the formation of heel spurs, but inflammatory diseases (e.g., arthritis) may also increase the occurrence of painful heel spurs. Treatments that have proven to be effective for heel spurs include injections that contain a combination of steroids and anesthesia as well as radiofrequency ablation. However, a bone spur that begins to protrude excessively may need to be removed through surgery.


Causes


Generally caused by lack of flexibility in the calf muscles and/or excess weight, heel spurs occur when the foot bone is exposed to constant stress and calcium deposit build-up on the bottom of the heel bone. Repeated damage can cause these deposits to pile up on each other, presenting a spur-shaped deformity.


Heel Spur


Symptoms


Symptoms may be similar to those of plantar fasciitis and include pain and tenderness at the base of the heel, pain on weight bearing and in severe cases difficulty walking. The main diagnosis of a heel spur is made by X-ray where a bony growth on the heel can be seen. A heel spur can occur without any symptoms at all and the athlete would never know they have the bony growth on the heel. Likewise, Plantar fasciitis can occur without the bone growth present.


Diagnosis


The proper diagnosis of a heel spur often requires an X-ray. To make this process as convenient for his patients as possible, most clinics have an on-site digital X-ray and diagnostic ultrasound machines. This can make it unnecessary for patients to visit diagnostic imaging centers, allowing patients to receive more expedient treatment.


Non Surgical Treatment


Heel spurs and plantar fascitis are usually controlled with conservative treatment. Early intervention includes stretching the calf muscles while avoiding re-injuring the plantar fascia. Decreasing or changing activities, losing excess weight, and improving the proper fitting of shoes are all important measures to decrease this common source of foot pain. Modification of footwear includes shoes with a raised heel and better arch support. Shoe orthotics recommended by a healthcare professional are often very helpful in conjunction with exercises to increase strength of the foot muscles and arch. The orthotic prevents excess pronation and lengthening of the plantar fascia and continued tearing of this structure. To aid in this reduction of inflammation, applying ice for 10-15 minutes after activities and use of anti-inflammatory medication can be helpful. Physical therapy can be beneficial with the use of heat modalities, such as ultrasound that creates a deep heat and reduces inflammation. If the pain caused by inflammation is constant, keeping the foot raised above the heart and/or compressed by wrapping with an ace bandage will help. Corticosteroid injections are also frequently used to reduce pain and inflammation. Taping can help speed the healing process by protecting the fascia from reinjury, especially during stretching and walking.


Surgical Treatment


Have surgery if no other treatments work. Before performing surgery, doctors usually give home treatments and improved footwear about a year to work. When nothing else eases the pain, here's what you need to know about surgical options. Instep plantar fasciotomy. Doctors remove part of the plantar fascia to ease pressure on the nerves in your foot. Endoscopy. This surgery performs the same function as an instep plantar fasciotomy but uses smaller incisions so that you'll heal faster. However, endoscopy has a higher rate of nerve damage, so consider this before you opt for this option. Be prepared to wear a below-the-knee walking cast to ease the pain of surgery and to speed the healing process. These casts, or "boots," usually work better than crutches to speed up your recovery time.


Prevention


o help prevent heel and bone spurs, wear properly designed and fitted shoes or boots that provide sufficient room in the toe box so as not to compress the toes. They should also provide cushioning in appropriate areas to minimize the possibility of the irritation and inflammation that can lead to bone spurs in the feet. If needed, use inserts that provide arch support and a slight heel lift to help ensure that not too much stress is placed on the plantar fascia. This helps to reduce the possibility of inflammation and overstress. Wearing padded socks can also help by reducing trauma. Peer-reviewed, published studies have shown that wearing clinically-tested padded socks can help protect against injuries to the skin/soft tissue of the foot due to the effects of impact, pressure and shear forces. Also consider getting your gait analyzed by a foot health professional for appropriate orthotics. If you have heel pain, toe pain or top-of-the-foot pain, see your doctor or foot specialist to ensure that a spur has not developed.

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