What are bone spurs and how do they form. What causes bone spurs to develop in joints. How are bone spurs diagnosed and treated. Can bone spurs be prevented through lifestyle changes.

Understanding Bone Spurs: Formation and Common Locations

Bone spurs, medically known as osteophytes, are smooth, hard protrusions of extra bone that develop on the ends of existing bones. These bony outgrowths typically form in joints where two bones meet. While bone spurs can occur in various parts of the body, they are most commonly found in the:

• Hands
• Shoulders
• Neck
• Spine
• Hips
• Knees
• Feet (particularly the heels)

Are bone spurs always problematic? Not necessarily. In many cases, bone spurs don’t cause any symptoms or issues. However, when they rub against other bones or press on nerves, they can lead to pain and stiffness in the affected area.

The Root Causes of Bone Spur Development

Understanding the underlying causes of bone spurs is crucial for effective prevention and management. The most common cause is joint damage resulting from osteoarthritis or degenerative joint disease. As we age, the cushioning between our joints and the bones of our spine can wear down, leading to the formation of bone spurs.

Other conditions that can contribute to bone spur development include:

• Rheumatoid arthritis
• Lupus
• Gout

Do injuries play a role in bone spur formation? Indeed, bone spurs often develop following an injury to a joint or tendon. When the body perceives bone damage, it attempts to repair it by adding bone to the injured area.

Additional factors that may contribute to bone spur formation include:

• Overuse of joints (e.g., frequent running or dancing over extended periods)
• Genetic predisposition
• Dietary factors
• Obesity
• Congenital bone abnormalities
• Spinal stenosis (narrowing of the spine)

Recognizing the Symptoms of Bone Spurs

How can you tell if you have a bone spur? Interestingly, many people with bone spurs are unaware of their presence until they undergo an X-ray for an unrelated condition. Symptoms typically arise only when the bone spur presses on nerves, tendons, or other structures in the body.

When symptoms do occur, they may include:

• Pain in the affected joint
• Pain or stiffness when attempting to bend or move the affected joint
• Weakness, numbness, or tingling in the arms or legs (if the bone spur presses on spinal nerves)
• Muscle spasms, cramps, or weakness
• Visible bumps under the skin, particularly in the hands and fingers
• In rare cases, difficulty controlling bladder or bowel functions (if the bone spur presses on specific nerves in the spine)

Do symptoms worsen with activity? Often, the discomfort associated with bone spurs intensifies during exercise or when attempting to move the affected joint.

The “Loose Body” Phenomenon

In some instances, a bone spur can break off and become lodged in the lining of the joint. This is referred to as a “loose body” and can significantly impair joint mobility, making movement difficult.

Diagnosing Bone Spurs: Medical Evaluation and Imaging Techniques

How are bone spurs diagnosed? The diagnostic process typically begins with an evaluation by your primary care physician, who may then refer you to a specialist. Rheumatologists, who specialize in joint problems, or orthopedic doctors, who focus on the musculoskeletal system, are often involved in the diagnosis and treatment of bone spurs.

The diagnostic process may include:

1. Physical examination: The doctor will palpate the joint to check for any bumps or abnormalities.
2. X-ray: This is the primary imaging technique used to visualize bone spurs.
3. CT scan: A more powerful X-ray that provides detailed images of the internal structures.
4. MRI: This technique uses magnets and radio waves to create detailed images of organs and structures within the body.
5. Electroconductive tests: These measure the speed at which nerves transmit electrical signals, helping to assess any damage caused by bone spurs to nerves in the spinal canal.

Treatment Options: From Conservative Approaches to Surgical Interventions

What treatment options are available for bone spurs? The approach to treating bone spurs varies depending on the severity of symptoms and the impact on daily life. Conservative treatments are often the first line of defense.

Over-the-Counter Pain Relief

To alleviate pain and reduce inflammation, over-the-counter pain relievers may be recommended, such as:

• Acetaminophen (Tylenol)
• Ibuprofen (Advil, Motrin)
• Naproxen sodium (Aleve)

It’s important to note that prolonged use of these medications can lead to side effects. If you’ve been using them for more than a month, consult your doctor about alternative treatments.

Additional Therapies

Other therapeutic approaches for managing bone spurs include:

• Rest: Allowing the affected joint to recover
• Steroid injections: To reduce inflammation and alleviate pain in the joint
• Physical therapy: Aimed at improving joint strength and increasing range of motion

Surgical Intervention

When conservative treatments prove ineffective or if the bone spur significantly impairs movement, surgical removal of the extra bone may be necessary.

Preventive Measures: Reducing the Risk of Bone Spur Formation

Can bone spurs be prevented? While it’s not always possible to prevent bone spurs, especially those resulting from the natural wear and tear associated with arthritis, there are steps you can take to reduce the risk of developing bone spurs from other causes:

• Wear appropriate footwear: Choose shoes with a wide toe box, good arch support, and adequate cushioning. Professional fitting can ensure your shoes don’t cause friction when walking.
• Maintain a balanced diet: Ensure your diet includes sufficient calcium and vitamin D to support bone health.
• Engage in regular exercise: Weight-bearing exercises like walking or stair climbing can help maintain bone strength.
• Manage your weight: Maintaining a healthy weight reduces stress on your joints.
• Seek early medical attention: If you notice signs of joint problems such as pain, swelling, or stiffness, consult your doctor promptly. Early diagnosis and treatment of arthritis may help prevent the damage that leads to bone spur formation.

Living with Bone Spurs: Lifestyle Adjustments and Long-Term Management

How can individuals effectively manage life with bone spurs? Living with bone spurs may require some lifestyle adjustments to minimize discomfort and maintain quality of life. Consider the following strategies:

Ergonomic Modifications

Adapting your work and home environments can significantly reduce strain on affected joints. This may include:

• Using ergonomic chairs and desks to maintain proper posture
• Employing assistive devices to reduce stress on joints during daily activities
• Adjusting sleeping positions and using supportive pillows to alleviate pressure on affected areas

Regular Exercise and Stretching

Maintaining an active lifestyle is crucial for managing bone spurs. Incorporate the following into your routine:

• Low-impact exercises such as swimming or cycling to maintain joint flexibility
• Stretching exercises to improve range of motion and reduce stiffness
• Strength training to support the muscles around affected joints

Stress Management

Chronic pain can be emotionally taxing. Implementing stress-reduction techniques can help manage both physical and emotional symptoms:

• Practice mindfulness meditation
• Engage in deep breathing exercises
• Consider cognitive-behavioral therapy to develop coping strategies

Dietary Considerations

While diet alone cannot cure bone spurs, certain nutritional choices may help manage symptoms:

• Incorporate anti-inflammatory foods such as fatty fish, berries, and leafy greens
• Stay hydrated to support joint health
• Consider supplements like glucosamine and chondroitin after consulting with your healthcare provider

Emerging Treatments and Research in Bone Spur Management

What new treatments are on the horizon for bone spur management? The field of orthopedics is continuously evolving, with researchers exploring innovative approaches to treat and prevent bone spurs. Some promising areas of research include:

Regenerative Medicine

Stem cell therapy and platelet-rich plasma (PRP) injections are being studied for their potential to promote healing and reduce inflammation in joints affected by bone spurs.

Advanced Imaging Techniques

Developments in imaging technology, such as high-resolution MRI and 3D modeling, are improving the accuracy of bone spur diagnosis and treatment planning.

Minimally Invasive Surgical Techniques

Advancements in surgical procedures are allowing for more precise removal of bone spurs with reduced recovery time and fewer complications.

Targeted Drug Delivery Systems

Researchers are exploring ways to deliver pain-relieving and anti-inflammatory medications directly to affected joints, potentially increasing efficacy while reducing systemic side effects.

When to Seek Medical Attention: Red Flags and Urgent Symptoms

How do you know when it’s time to consult a healthcare professional about bone spurs? While many cases of bone spurs can be managed with conservative treatments, certain symptoms warrant immediate medical attention:

• Sudden, severe pain in a joint or along the spine
• Rapid onset of weakness or numbness in the limbs
• Loss of bladder or bowel control
• Difficulty walking or maintaining balance
• Visible deformity in a joint
• Fever accompanying joint pain, which could indicate infection

Early intervention can prevent complications and improve outcomes, so don’t hesitate to seek medical advice if you experience any concerning symptoms.

The Impact of Bone Spurs on Quality of Life: Coping Strategies and Support

How do bone spurs affect daily life, and what support is available for those living with this condition? The impact of bone spurs on quality of life can vary greatly depending on their location and severity. For some, bone spurs may cause minimal disruption, while for others, they can significantly affect mobility and daily activities.

Emotional and Psychological Impact

Living with chronic pain or limited mobility can take a toll on mental health. It’s important to address these aspects of bone spur management:

• Seek support from friends, family, or support groups
• Consider counseling or therapy to develop coping strategies
• Explore relaxation techniques such as yoga or tai chi

Occupational Adjustments

For those whose work is affected by bone spurs, consider the following:

• Discuss workplace accommodations with your employer
• Explore alternative work arrangements, such as flexible hours or telecommuting
• Consider vocational rehabilitation if a career change is necessary

Community Resources

Many communities offer resources for individuals living with chronic conditions like bone spurs:

• Local support groups for arthritis or chronic pain
• Community exercise programs tailored for individuals with joint issues
• Educational workshops on pain management and self-care techniques

By addressing both the physical and emotional aspects of living with bone spurs, individuals can maintain a high quality of life and continue to engage in meaningful activities despite their condition.

Causes, Symptoms, Diagnosis, Treatment, & Prevention

Written by WebMD Editorial Contributors

• What Are Bone Spurs?
• Causes of Bone Spurs
• Symptoms of Bone Spurs
• Bone Spur Diagnosis
• Bone Spur Treatments and Home Care
• Bone Spur Prevention
• More

Bone spurs (also called osteophytes) are smooth, hard bumps of extra bone that form on the ends of bones. They often pop up in the joints — the places where two bones meet.

Bone spurs can form on many parts of your body, including your:

• Hands
• Shoulders
• Neck
• Spine
• Hips
• Knees
• Feet (heels)

Most bone spurs don’t cause problems. But if they rub against other bones or press on nerves, you might experience pain and stiffness.

The most common cause of bone spurs is joint damage from osteoarthritis or degenerative joint disease. The cushioning between your joints and the bones of your spine can wear down with age. Rheumatoid arthritis, lupus, and gout can also damage your joints.

Bone spurs also often form after an injury to a joint or tendon. When your body thinks your bone is damaged, it tries to fix it by adding bone to the injured area.

Other causes of bone spurs include:

• Overuse – for example, if you run or dance a lot over a long period of time
• Genes
• Diet
• Obesity
• Bone problems that you were born with
• Narrowing of the spine (spinal stenosis)

You might not realize you have a bone spur until you get an X-ray to look for another condition. They only cause problems when they press on nerves, tendons, or other structures in your body. Then, you might feel any of the following:

• Pain in the affected joint
• Pain or stiffness when you try to bend or move the affected joint
• Weakness, numbness, or tingling in your arms or legs if the bone spur presses on nerves in your spine
• Muscle spasms, cramps, or weakness
• Bumps under your skin, seen mainly in the hands and fingers
• Trouble controlling your bladder or bowels if the bone spur presses on certain nerves in your spine (a symptom that’s seen very rarely)

Your symptoms might get worse when you exercise or try to move the affected joint.

A bone spur can break off and get stuck in the lining of the joint. This is called a “loose body.” It can lock up the joint and make it hard to move.

Often, bone spurs are first evaluated by your regular doctor who will likely refer you to a specialist. You’ll probably need to see a rheumatologist or orthopedic doctor. Rheumatologists specialize in joint problems. Orthopedic doctors focus on the musculoskeletal system. Your doctor will feel the joint to check for a bump. They may also order an X-ray to help them to see the bone spur better.

Other tests your doctor can use to diagnose bone spurs include:

• CT scan. It’s a powerful X-ray that makes detailed pictures inside your body.
• MRI. This uses powerful magnets and radio waves to make pictures of organs and structures inside your body.
• Electroconductive tests. These tests measure how fast your nerves send electrical signals. They can show the damage bone spurs have caused to nerves in your spinal canal.

To relieve pain and bring down swelling, you can try one of these over-the-counter pain relievers:

• Acetaminophen (Tylenol)
• Ibuprofen (Advil, Motrin)
• Naproxen sodium (Aleve)

These can cause side effects, especially if you take them in large doses or for a long time. If you’ve taken them for more than a month, ask your doctor if you can try a different treatment.

Other therapies for bone spurs include:

• Rest
• Steroid shots to bring down swelling and reduce pain in the joints
• Physical therapy to improve joint strength and increase movement

If these treatments don’t work or the bone spur affects your movement, you might need surgery to remove the extra bone.

Bone spurs usually can’t be prevented if they’re the result of the natural wear and tear of arthritis. But you can take these steps to avoid bone spurs caused by other things:

• Wear shoes with a wide toe box, good arch support, and enough cushion to pad each step. Get your shoes fitted by a professional so they don’t rub against your feet when you walk. Wear thick socks to prevent your shoes from rubbing.
• Eat a well-rounded diet with plenty of calcium and vitamin D to protect your bones.
• Do regular weight-bearing exercises like walking or stair climbing to keep your bones strong.
• Try to keep the extra pounds off.

See your doctor if you have any signs of joint trouble, like pain, swelling, or stiffness. If you catch and treat arthritis early, you may be able to prevent the damage that leads to bone spurs.

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Causes, Symptoms, Diagnosis, Treatment, & Prevention

Written by WebMD Editorial Contributors

• What Are Bone Spurs?
• Causes of Bone Spurs
• Symptoms of Bone Spurs
• Bone Spur Diagnosis
• Bone Spur Treatments and Home Care
• Bone Spur Prevention
• More

Bone spurs (also called osteophytes) are smooth, hard bumps of extra bone that form on the ends of bones. They often pop up in the joints — the places where two bones meet.

Bone spurs can form on many parts of your body, including your:

• Hands
• Shoulders
• Neck
• Spine
• Hips
• Knees
• Feet (heels)

Most bone spurs don’t cause problems. But if they rub against other bones or press on nerves, you might experience pain and stiffness.

The most common cause of bone spurs is joint damage from osteoarthritis or degenerative joint disease. The cushioning between your joints and the bones of your spine can wear down with age. Rheumatoid arthritis, lupus, and gout can also damage your joints.

Bone spurs also often form after an injury to a joint or tendon. When your body thinks your bone is damaged, it tries to fix it by adding bone to the injured area.

Other causes of bone spurs include:

• Overuse – for example, if you run or dance a lot over a long period of time
• Genes
• Diet
• Obesity
• Bone problems that you were born with
• Narrowing of the spine (spinal stenosis)

You might not realize you have a bone spur until you get an X-ray to look for another condition. They only cause problems when they press on nerves, tendons, or other structures in your body. Then, you might feel any of the following:

• Pain in the affected joint
• Pain or stiffness when you try to bend or move the affected joint
• Weakness, numbness, or tingling in your arms or legs if the bone spur presses on nerves in your spine
• Muscle spasms, cramps, or weakness
• Bumps under your skin, seen mainly in the hands and fingers
• Trouble controlling your bladder or bowels if the bone spur presses on certain nerves in your spine (a symptom that’s seen very rarely)

Your symptoms might get worse when you exercise or try to move the affected joint.

A bone spur can break off and get stuck in the lining of the joint. This is called a “loose body.” It can lock up the joint and make it hard to move.

Often, bone spurs are first evaluated by your regular doctor who will likely refer you to a specialist. You’ll probably need to see a rheumatologist or orthopedic doctor. Rheumatologists specialize in joint problems. Orthopedic doctors focus on the musculoskeletal system. Your doctor will feel the joint to check for a bump. They may also order an X-ray to help them to see the bone spur better.

Other tests your doctor can use to diagnose bone spurs include:

• CT scan. It’s a powerful X-ray that makes detailed pictures inside your body.
• MRI. This uses powerful magnets and radio waves to make pictures of organs and structures inside your body.
• Electroconductive tests. These tests measure how fast your nerves send electrical signals. They can show the damage bone spurs have caused to nerves in your spinal canal.

To relieve pain and bring down swelling, you can try one of these over-the-counter pain relievers:

• Acetaminophen (Tylenol)
• Ibuprofen (Advil, Motrin)
• Naproxen sodium (Aleve)

These can cause side effects, especially if you take them in large doses or for a long time. If you’ve taken them for more than a month, ask your doctor if you can try a different treatment.

Other therapies for bone spurs include:

• Rest
• Steroid shots to bring down swelling and reduce pain in the joints
• Physical therapy to improve joint strength and increase movement

If these treatments don’t work or the bone spur affects your movement, you might need surgery to remove the extra bone.

Bone spurs usually can’t be prevented if they’re the result of the natural wear and tear of arthritis. But you can take these steps to avoid bone spurs caused by other things:

• Wear shoes with a wide toe box, good arch support, and enough cushion to pad each step. Get your shoes fitted by a professional so they don’t rub against your feet when you walk. Wear thick socks to prevent your shoes from rubbing.
• Eat a well-rounded diet with plenty of calcium and vitamin D to protect your bones.
• Do regular weight-bearing exercises like walking or stair climbing to keep your bones strong.
• Try to keep the extra pounds off.

See your doctor if you have any signs of joint trouble, like pain, swelling, or stiffness. If you catch and treat arthritis early, you may be able to prevent the damage that leads to bone spurs.

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Heel spur – causes, symptoms, diagnosis and treatment

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Heel spur: causes, symptoms, diagnosis and treatment.

Definition

Heel spur, or plantar fasciitis, is a disease of the feet with a characteristic chronic aseptic (without bacterial agent) inflammation in the area of ​​attachment of the large ligament on the sole of the foot (plantar aponeurosis, or fascia) to the calcaneus. Plantar fasciitis usually forms on the back or underside of the heel bone, resembling a spur, hence its name.

Causes of heel spurs

The plantar fascia is a bundle of fibers that connects the calcaneal tuberosity to the phalanges of the fingers. It helps to maintain the shape of the foot and arch of the foot. The normal anatomy of the foot is designed so that a person does not feel pain when walking – for this there is a plantar aponeurosis, which plays the role of a shock absorber (bridge) for the arch of the foot.

One of the modern theories explaining the formation of heel spur syndrome is that the inflammation is caused by chronic microtraumatization of the aponeurosis when it is stretched.

As a result of the incorrect position of the bones of the foot relative to each other during walking, a constant overstretching of the ligament occurs, leading to the appearance of small tears, swelling and pain. As a result of repeated ruptures, inflammation and shortening of the fibers of the plantar aponeurosis occur, they lose their elasticity. Pathological feedback is switched on: the more microtears, the stronger the inflammation, the shorter the ligaments, the more often microtears. Forced protection of the body from injuries and ruptures is the strengthening of the fibers of the plantar aponeurosis in the area of ​​​​attachment to the calcaneus. The next stage is the formation of osteophytes on the calcaneus, which are called “calcaneal spur”. Thus, the growth on the calcaneus itself is only a reaction of the body to inflammation, but not the root cause of pain.

Predisposing factors for the development of spurs are flat feet, overweight, excessive overload of the foot, very high or low arch of the foot, congenital and acquired deformities of the feet, scoliosis, osteochondrosis, deforming arthrosis of the hip or knee joints, arthritis of various etiologies, diabetes mellitus.

The disease is often diagnosed in professional athletes, runners and dancers, as well as in people whose work is associated with a long stay in a standing position, with prolonged walking on a hard surface, and frequent carrying of weights.

Heel spurs are more common in women over the age of 40-45.

Perhaps this is due to the regular wearing of high-heeled shoes. In 90% of cases, the disease develops against the background of flat feet, in which the distribution of the load on the foot changes and overstretching of the plantar fascia occurs.

Classification of the disease

According to the international classification of diseases ICD-10, heel spur (M77.3) refers to diseases of the musculoskeletal system and connective tissue. Heel spurs can be unilateral or bilateral, that is, on the soles of one or both feet.

Heel spur symptoms

The disease has such characteristic symptoms that it is simply impossible not to notice it or confuse it with any other pathology. Typical symptoms of plantar fasciitis:

• burning, stabbing pain in the heel;
• the focus of pain is deep, right in front of the heel and more often on the inside of the heel;
• the pain is more acute in the morning and at the end of a tiring day;
• the pain increases with prolonged standing, sitting;
• the first steps after sleep are especially painful, and as you walk, the pain subsides a little;
• worries more when walking barefoot, in flat shoes without a heel;
• pain may be present in both feet, but usually one leg hurts more;
• wrong turn of the foot, clubfoot.

Pain occurs in the central and medial parts of the plantar surface of the calcaneal region during palpation, with pressure on the tubercle of the calcaneus, with squeezing of the heel on both sides. Thumb extension can also cause increased heel pain.

With a posterior heel spur, pain is observed at the site of attachment of the Achilles tendon when walking and pressure with the back of the shoe.

There is no relationship between spur size and symptom severity. Many large spurs are asymptomatic, small spurs can cause unbearable pain, and many patients present with severe complaints, although there is no evidence of spurs on x-rays.

Heel spur diagnosis

Evaluation of patients with heel pain begins with an assessment of general health (including history of heel pain treatment), occupation, hobbies, weight change, or coincidence of onset of symptoms with increased physical activity.

To clarify the diagnosis of heel spurs, various instrumental methods are used:

• X-ray of the heel region is necessary to exclude a fracture if there are indications of trauma in the anamnesis. In the early stages of formation, the heel spur is not visualized on the radiograph.

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X-ray examination of the foot in two projections allows diagnosing injuries and other pathological changes, including flat feet.

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MRI of soft tissues of one limb segment

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Ultrasound diagnostics can be used to assess the condition of the soft tissues of the foot, identify a possible abscess, and monitor the effectiveness of treatment.

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Additional examination methods include:

• general and biochemical blood tests to detect inflammation, assess the level of uric acid;

C-reactive protein (CRP, CRP)

C-reactive protein is an acute phase protein, a sensitive indicator of tissue damage during inflammation, necrosis, trauma.
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Which doctors to contact

Traumatologists-orthopedists and surgeons deal with foot pathology. The necessary list of physiotherapeutic procedures, massage and therapeutic exercises is prescribed by a physiotherapist. In the presence of concomitant diseases, appropriate laboratory and instrumental studies, consultations of narrow specialists may be required.

Heel spur treatment

One of the main goals of heel spur treatment is to control pain and relieve inflammation. The real effect can be obtained only with an integrated approach.

Foot unloading method . The most effective way of treatment is to return the foot to the correct position when walking, restore the arch of the longitudinal arches and reduce pressure on the heel region. It is considered rational to wear orthopedic shoes that prevent overstretching of the plantar ligament and have the maximum shock-absorbing effect, creating comfort while walking.

One of the most affordable options is the manufacture of individual instep supports that make it possible to physiologically position the foot.

Drug therapy . Currently, drugs from the group of non-steroidal anti-inflammatory drugs in the form of ointments and creams are used to treat heel spurs. tablet or injectable forms. It is worth noting that this is a symptomatic method of treatment that does not give a persistent analgesic effect and does not affect the course of the disease, and also has many undesirable side effects.

Corticosteroids are commonly used to reduce pain and inflammation. Although plantar fasciitis is a degenerative rather than an inflammatory process, as evidenced by the short-term therapeutic effect of corticosteroids. The most common in the treatment of heel spurs are injections of hormonal drugs.

Tension of the calf muscles aggravates the course of the disease and increases heel pain, so muscle relaxants can be used to reduce it.

In combination with analgesics, they significantly increase the effectiveness of treatment and reduce the dose of painkillers.

Physiotherapy:

• electrophoresis with hyaluronidase or 5% calcium chloride solution: introduction of drugs into the thickness of tissues using electric current;
• sonophoresis with hydrocortisone: treatment of tissues with ultrasonic waves that improve the penetration of drugs;
• ultrasonic therapy: heating of tissues and reduction of inflammatory reactions with the help of ultrasonic waves;
• magnetotherapy;
• mud and mineral baths;
• laser therapy: heating the deep layers of tissues with a laser helps locally improve blood flow.

Shock wave therapy is a non-invasive method of treatment that allows you to reduce or completely remove pain in a short time. The technique is based on the impact of ultrasonic waves of a certain frequency in order to destroy calcium deposits, reduce inflammation and relieve swelling, and activate tissue regeneration. Under the influence of the shock wave, blood circulation increases, the permeability of cell membranes changes and cell ion exchange is restored, thereby providing anti-inflammatory and anti-edematous effects.

Therapeutic exercise and massage . In the subacute period, when the intensity of pain has decreased, physical exercises are added to the treatment aimed at stretching the calf muscles of the lower leg and plantar fascia, improving the mobility of the ankle joint, as well as strengthening the muscles responsible for the correct positioning of the foot during movement. Massage improves metabolic processes in tissues, removes pain associated with reflex muscle spasm.

Therapeutic physical training and massage are aimed at correcting the biomechanics of the body, which can significantly alleviate the course of the disease and is the prevention of its relapse.

Surgical treatment . The only way to get rid of a large heel spur is through surgery. When choosing the classic version of the operation, the surgeon cuts the fascia completely and removes the bony protrusion. A more modern and sparing technique is radiofrequency microtenotomy. The essence of the operation is to eliminate damaged tissues using radiofrequency waves.

Local injection of hormones (corticosteroids) at the site of inflammation and surgery are extreme measures, which are resorted to only in cases where other methods of treatment have not brought the desired result.

In complex cases characterized by a long and recurrent course, surgical treatment is the only method.

Complications

The main complication of heel spurs is a deterioration in the quality of life associated with pain and the inability to lead an active lifestyle. In patients, sleep is often disturbed, anxiety and irritability increase. They are forced to avoid relying on a sore heel and transfer weight to a healthy limb. This negatively affects gait and posture and increases the risk of damage to the joints of the loaded limb. With a pronounced pain syndrome, asymmetry of posture appears, which leads to the progression of osteochondrosis and the occurrence of pain in the lumbar region. As a result, the patient is forced to limit motor activity.

Other complications such as avulsion of the fascia and suppuration are rare.

Heel spur prevention

The development of a heel spur is preventable in most cases. It is recommended to ensure regular rest of the feet in combination with the right exercises, take breaks to warm up at work, if it is associated with a constant load on the feet.

Shoes should be comfortable, and in the presence of flat feet – orthopedic.

It is useful to wear individual orthopedic insoles that are adjacent to the foot over the entire area – they allow you to restore the normal height of the arch of the foot and, thus, reduce the tension of the plantar fascia already in the first weeks of constant wear.

To reduce the severity of pain in the heel region and reduce the load on the plantar aponeurosis, you should take shorter steps, do not walk barefoot, avoid running, dancing, wearing irrational shoes.

Sources:

1. Reznik L.B., Erofeev S.A., Silantiev V.N., Turushev M.A., Kuznetsov N.K. The current state of the problem of surgical treatment of plantar fasciosis (literature review). Orthopedic genius, magazine. T. 24. No. 4, 2018. S. 515-520.
2. Bone spurs. Big Medical Encyclopedia (BME), edited by Petrovsky B.V., 3rd edition, volume 27.

IMPORTANT!

The information in this section should not be used for self-diagnosis or self-treatment. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For diagnosis and proper treatment, you should contact your doctor.
For a correct assessment of the results of your analyzes in dynamics, it is preferable to do studies in the same laboratory, since different laboratories may use different research methods and units of measurement to perform the same analyzes.

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Heel spur – treatment, symptoms, causes, diagnosis

Video

• Heel spur. Question answer.
  Subject: Q&A
• Heel spur
  Subject: Encyclopedia of diseases

Title

• Causes of disease
• Symptoms
• Diagnostics
• Treatments for heel spurs

SHOCK WAVE THERAPY –
the most effective treatment for
HEAL SPUR!

Read more

Heel spur is a calcium deposit on the underside of the heel bone. On x-ray, the heel spur may protrude 0.5-1 cm forward. Although heel spurs are often painless, they can still be quite painful. Heel spurs are often associated with plantar fasciitis. Plantar fasciitis is the most common cause of pain in the bottom of the heel. Approximately 2 million patients in the US are treated for plantar fasciitis each year. Plantar fasciitis occurs when the strong band of tissue that supports the arch of the foot (plantar fascia) becomes irritated and inflamed. Heel spurs on the back of the heel are also often associated with inflammation of the Achilles tendon (tendinitis) and can cause soreness and pain in the back of the heel that worsens with foot extension.

Heel spurs and plantar fasciitis can occur by themselves or be caused by the presence of diseases such as arthritis (including Reiter’s reactive arthritis), ankylosing spondylitis, diffuse idiopathic hyperostosis. It is important to note that a heel spur may not cause any symptoms at all, and may be discovered incidentally during an X-ray examination.

Cause

A heel spur occurs when calcium deposits form on the underside of the heel bone and this is a process that usually occurs over many months. Heel spurs are often caused by stretching of the muscles and ligaments, stretching of the plantar fascia, and repeated ruptures of the membrane that covers the heel bone. Heel spurs are especially common in athletes whose sports activities are associated with a lot of jumping and running.

Risk factors for heel spurs include:

• Impaired gait that places excessive stress on the heel bone, ligaments, and nerves in the heel area.
• Running on hard surfaces
• Poorly fitted or worn shoes
• Overweight, obesity

In most cases, plantar fasciitis develops without a specific cause.

But there are certain risk factors that increase the chance of developing plantar fasciitis and include:

• Old age. Involutional changes in the tissues leads to a decrease in the elasticity of the plantar fascia and a decrease in adipose tissue in the heel area
• Diabetes
• Activities involving standing for long periods of time
• Episodes of intense physical activity
• The presence of flat feet or vice versa high arch of the foot.
• Gastrocnemius thickening and limited foot flexion.

The function of the plantar fascia is to absorb the loads that fall on the foot. But at a certain point, the fascia cannot withstand the loads, and tears and inflammation of the fascia occur.

Symptoms

Although many patients with plantar fasciitis have a heel spur, the spur does not always cause pain. Almost 10% of adults have spurs, but only 5% have foot pain. And therefore, the treatment of heel pain, most often, does not require the removal of the spur.

The most common symptoms of plantar fasciitis are:

• Pain in the lower part of the foot near the heel
• Pain on first steps after getting out of bed in the morning, or after a long period of rest, such as after a long car ride. Pain lessens after a few minutes of walking
• Increased pain after (not during) exercise or physical activity.

Heel spurs often cause no symptoms. But heel spurs can lead to occasional pain or chronic pain – especially when walking or jogging if inflammation develops at the site of the spur. In general, the cause of the pain is not the heel spur itself, but trauma to the soft tissues of this spur.

Many patients describe heel spur pain and plantar fasciitis, like a pin sticking out of the bottom of the foot when they get up in the morning and this pain later becomes a dull ache. Also characteristic is the complaint that acute pain also appears immediately when standing up, after sitting for a long period of time the presence of mobility restrictions in the foot. To verify the diagnosis, instrumental methods of research may be required. Radiography provides a clear image of bone tissue. This research method makes it possible to exclude other causes of heel pain, such as a fracture or arthrosis. The heel spur is well visualized on x-ray.

MRI is a very informative research method that allows you to visualize well not only the bone tissues of the foot, but also soft tissues (ligaments, cartilage tissue), which is important in diagnosing damage to the plantar fascia, Achilles tendon or cartilage tissue damage in arthritis.

Ultrasound examination is also widely used for diagnosis of heel spurs and plantar fasciitis and, although it is inferior to MRI in image quality, but given the complete safety, it can be used quite often, for example, to monitor the effectiveness of treatment.

Treatment

Heel spur treatment can be conservative or surgical. In 90% of patients with plantar fasciitis (heel spur), conservative treatment is effective within 10 months.

Conservative methods of treatment include:

Drug treatment includes the use of NSAIDs (ibuprofen, voltaren, naproxen), which can be used both orally in the form of tablets and topically, in the form of ointments, gels containing NSAIDs. In some cases, it is possible to use injections of corticosteroids, which allows you to quickly remove the inflammatory process. A corticosteroid may be injected into the plantar fascia to reduce inflammation and pain. But repeated steroid injections can lead to rupture of the fascia, and therefore the use of steroids must be clearly indicated.

Extracorporeal shock wave therapy (ESWT). During this treatment, powerful sound wave pulses break up the calcium deposits in the heel spur and stimulate the regeneration process in the plantar fascia.