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Heel spurs diagnosis: Causes, Symptoms, Diagnosis, Treatment, & Prevention


Causes, Symptoms, Diagnosis, Treatment, & Prevention

What Are Bone Spurs?

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:

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

Causes of Bone Spurs

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)

Symptoms of Bone Spurs

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.

Bone Spur Diagnosis

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.

Bone Spur Treatments and Home Care

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

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 Spur Prevention

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.

What Is a Heel Spur? Heel Spur Symptoms, Treatment and Recovery

What Is a Heel Spur? Heel Spur Symptoms, Treatment and Recovery

The average American takes more than 5,000 steps every single day. Over the course of our lifetimes, these small steps add up to tens of thousands of miles, and this mileage can wear on our feet, resulting in various injuries and chronic conditions. For approximately 10 percent of people, these wear-and-tear foot injuries will eventually include heel bone spurs. Heel bone spurs are small, bony protrusions that can severely limit mobility and make even walking around the home a burdensome and painful chore. Fortunately, many patients suffering from foot pain related to bone spurs can experience symptom relief with nonsurgical options. In this post, we will answer many of the most frequently asked questions pertaining to bone spurs. So what are bone spurs, and what are your bone spur treatment options? Let’s take a look…

Bone Spur Symptoms: What Is a Heel Spur?

Before we touch on heel spur treatment, let’s first discuss what causes these painful spurs in the first place. Heel spurs are basically just excess calcium deposits that collect on the bottom of the calcaneus, also known colloquially as the heel bone, over a long period of time. The formation of these bony growths may be related to other conditions or lifestyle factors. For example, improperly fitting or poorly padded shoes may lead to the development of heel spurs. Overweight individuals have an increased risk of developing heel bone spurs, as do individuals with arthritis and certain gait abnormalities, such as overpronation (also known as flat feet). Strain on the bones and connective tissues of the foot from exercises such as running and jogging may also contribute to the growth of heel bone spurs.

How Do You Know If You Have a Heel Spur? Bone Spur Symptoms

Regardless of the underlying cause, there are many common heel spur symptoms. Many individuals will experience more pronounced heel spur pain early in the morning or after extended rest. For some, heel spur pain may manifest as a sharp pain along the bottom of the foot. Heel spur pain may also be mild and exist as a dull ache throughout the day, especially during and after rigorous activities. Other foot bone spur symptoms include inflammation and tenderness along the bottom of the foot, known as plantar fasciitis. With larger bone spurs, there may even be a visible protrusion where the spur has formed. A physical examination and other diagnostic imaging may also be utilized to properly diagnose the underlying cause of a patient’s mild or severe heel pain. It’s important to note, however, that not all heel spurs will result in discomfort or pain. In fact, only about 5 percent of individuals with heel bone spurs will experience foot pain, according to the American Academy of Orthopedic Surgeons.

Heel Spur Pain Relief: Heel Spur Treatment Options

Once the condition has been properly diagnosed, your healthcare provider will recommend appropriate heel bone spur treatment. Fortunately, many patients are able to achieve adequate relief from bone spur pain with nonsurgical heel spur treatment. In fact, “more than 90 percent of patients with plantar fasciitis will improve within 10 months of starting simple treatment methods,” according to the American Academy of Orthopedic Surgeons. In many cases, this treatment may include lifestyle adjustments. For patients who are overweight, losing excess pounds may help reduce the stress on the affected foot and heel during weight-being activities. For athletes suffering from bone spur pain, it may be necessary to reduce the intensity and frequency of activities known to cause symptom flare-ups. For those with milder heel spur symptoms, it may be possible to perform adequate heel spur treatment at home, with a regimen of rest, ice, compression, and elevation. (To learn more about the RICE method, feel free to read our recent blog post on effective ice and heat therapy.) Additionally, nonsteroidal anti-inflammatory medication (NSAIDs) can be taken to assist with general pain and swelling following rigorous activities and during symptom flare-ups. Because some bone spur pain symptoms are associated with tight muscles and connective tissues in the foot and lower leg, other heel spur treatment at home may take the form of a daily stretching regimen.

A basic calf stretch can be achieved by simply placing the balls of your feet along the edge of a step while facing upstairs, and then slowly and safely lowering your heels. Seated stretches may also be achieved using assistive bands to pull the tops of the feet toward the body. A healthcare provider may recommend more targeted exercises designed to stretch the plantar fascia, and these are often most effective when performed early in the day prior to rigorous activity. Night splints may also be used to keep the ligaments of the foot, namely the plantar fascia, relaxed during the night. Properly fitting shoes, heel pads to cushion the bottom of the foot, and inserts to minimize gait abnormalities (such as high arches or overpronation) may be beneficial. These assistive devices and inserts may help reduce strain along the plantar fascia.

Depending on the severity of the condition, a provider may recommend a complete physical therapy regimen, involving both stretches and other heel spur exercises to reduce pain and discomfort. In these cases, a therapist will tailor a physical therapy regimen to the individual patient. Once the patient feels comfortable, these exercises for plantar fasciitis and heel spur pain may be performed independently at home. Cortisone heel spur injections may also help reduce pain and swelling. However, it’s important to note that these shots will only offer temporary heel spur pain relief, and patients will need to return for cortisone heel spur injections throughout the year for long-lasting results.

What Is Heel Spur Surgery?

If the previous nonsurgical treatment options have failed to relieve a person’s heel spur pain, surgery may be necessary. Once your specific condition has been diagnosed, your provider will discuss your specific heel spur surgery options. Heel spurs may develop alongside other conditions, namely plantar fasciitis, and this will affect treatment options. Plantar fasciitis is an inflammation of the plantar fascia ligament that runs along the bottom of the foot, which can lead to the development of bone growths along the heel. The pain associated with this type of heel spur is often specifically associated with the inflamed ligament itself. If this is the case, your doctor may recommend a procedure known as plantar fascia release. During a plantar fascia release surgery, the surgeon will remove a portion of the ligament to reduce inflammation and pain. This procedure may be performed as an endoscopic or open procedure. The endoscopic procedure will involve smaller incisions and shorter recovery times than the open procedure. Your doctor will recommend one of these procedures based on your specific condition. In some cases, it may be necessary to remove the heel spur as well, although heel spur removal surgery is less common than the previously mentioned strategies. Generally, your provider will only recommend heel bone spur removal after the previous heel spur treatment options have failed to offer symptom relief. During heel spur removal surgery, the surgeon will remove the calcium deposit along the heel. This procedure may also be either open or endoscopic, and like plantar fascia release, this will vary on a case-by-case basis.

Heel Spur Surgery Recovery Time:

Following heel spur surgery, individuals should anticipate wearing a bandage over the incision for up to two weeks. Crutches are often used to assist with weight-bearing activities during the heel spur surgery recovery process. Over-the-counter pain medications can help with mild pain and discomfort. The RICE method should be used to help minimize pain and swelling immediately after surgery. Bandages and wraps may be used to achieve compression. Keeping the surgically treated foot elevated (ideally above the heart) will also minimize swelling. While most patients should expect a heel spur surgery recovery time of a few weeks, it may take up to three months for some patients to make a full recovery following heel bone spur surgery.

Today, effective bone spur treatment is enabling millions of individuals to live an active, pain-free lifestyle for decades to come. At Sports Medicine Oregon, we can provide the latest conservative care treatments at our state-of-the-art facility, with services ranging from outpatient physical therapy and the latest regenerative injections to minimally invasive surgery. If you or a loved one are dealing with bone spur pain and discomfort, our experienced medical team will tailor a specific treatment strategy based on your specific injury or condition, to help you live the active, pain-free lifestyle of your dreams. Please consult with our providers to see which treatment would work best for your foot issues.

Remember, we update our Sports Medicine Oregon blog monthly, so be sure to tune in often to stay up to date on the latest sports medicine news and views!

Heel Spurs | Orthopaedic Associates of St. Augustine

Heel Sp11urs

Heel spurs are a common foot ailment that is often confused with plantar fasciitis. While the two are similar and related, they are in fact separate diagnoses. Heel spurs are hooked, pointed, or shelf-shaped calcium deposits that form on the bone. The heel spurs themselves do not sense pain, rather they protrude and prod the soft tissues of the heel, causing pain and discomfort.

Causes and Symptoms of Heel Spurs

Heel spurs are a common ailment in patients who have a history of foot pain associated with plantar fasciitis. It occurs when the plantar fascia ligament, located on the arch of the foot, becomes fatigued, damaged, or inflamed. As this ligament is subjected to these stresses the body attempts to compensate through the buildup of calcium on the bone, leading to the formation of spurs. This is the body’s way of attempting to alleviate the stress on the worn ligament.

The condition can generally stem from the following issues:

  • An uneven gait which applies too much pressure to certain areas of the foot
  • Obesity, which can cause unnecessary pressure on the plantar fascia ligament
  • Wearing worn out shoes or ill-fitting footwear
  •  Job conditions that require long periods spent standing, lifting heavy objects, or even sitting for long periods of time
  • Exercising before warming up first
  • Repetitive impact against hard surfaces
  • The normal aging process which results in a decrease in ligament elasticity

Heel spurs often do not present any symptoms and are usually discovered with a diagnosis of plantar fasciitis. The pain associated has been described as a sharp needle or knife like sensation. Many experience this pain after sitting for prolonged periods of time or on standing for the first thing in the morning. Other symptoms include:

  • Pain on the bottom of the foot, in particular, near the heel
  • Great pain after exercise or activity (not during)
  • Limited “upward” motion of your ankle
  • Pain that intensifies upon flexing the ankle upwards while placing pressure on the heel

Diagnoses and Treatment of Heel Spurs

A sharp pain in the heel region is often all that is needed to confirm the presence of heel spurs. Doctors may also use an x-ray to visually confirm their presence. Many patients often find relief in the form of non-operative treatments and only in extreme cases does it require surgery for their removal. Some simple treatments include:

  • Resting and avoiding activities that cause pain for a period of time
  • Applying ice to the heel pain to reduce swelling and subsequent irritation of the tissue surrounding the spur
  • Stretching exercises to relax the tissue near the heal
  • Anti-inflammatory medications
  • Custom shoe insert or orthotics
  • Night splints designed to stretch the heel

Again, surgery is often times a last resort for patients who cannot find relief in the noninvasive solutions mentioned above. The Foot and Ankle Center at Orthopaedic Associates of St. Augustine have some of the best specialists and surgeons around. If you would like to make an appointment to treat or learn more about preventing and resolving foot pain, please contact us at 904-825-0540.

What are Heel Spurs? Learn Symptoms, Causes, and Treatment

It shouldn’t hurt to get on your feet in the morning or walk throughout the day. If you notice a sharp, stabbing sensation in your heel with each step you take, you may be suffering from heel spurs.

What Is A Heel Spur?

A heel spur is the excess build-up of the calcium deposits over a long time on the calcaneal bone, commonly known as the heel bone, leading to a bony outgrowth formation. The bony outgrowth can appear as hooked, pointy, or shelf-shaped, and differs in size from one individual to another, however, it can grow up to half an inch in length. Heel spurs can be linked to excessive strain, abnormal biomechanics, or less commonly, underlying health conditions.

A heel spur can either be a plantar heel spur, which is the most common and exists on the bottom of the feet, or a posterior heel spur that forms on the back of the heel.

Calcaneal spurs are a common condition, a study has reported that on average, 32% of people have plantar heel spurs, while about 13% experience posterior heel spurs. The highest incidence of 41.8% was detected in those over the age of 70 years old, and females were reported to have a higher incidence of developing posterior heel spurs than males. (1)

Despite being a fairly common condition, not everyone will experience pain as a result of growing heel spurs a large number of the cases are discovered accidentally during x-ray tests that were ordered for other feet issues. However, when the pain is felt due to heel spurs, it can be intense and interfere with everyday normal activities.

What are the types of heel spurs?

Heel bone spurs are categorized, based on their location, into the following:

Plantar calcaneal spur:

Plantar calcaneal spurs are the most common type and are also known as heel spur syndrome. It involves the formation of the bony projection in the plantar area (the bottom of the heel), they typically grow where the calcaneal bone connects to the plantar fascia, which is a collagenous fibrous tissue band stretching across the bottom of the foot. Hence, this type of heel spurs is commonly mistaken with plantar fasciitis, which is a degenerative condition of the plantar fascia, and despite it coexisting with plantar fasciitis in a large number of cases, these 2 conditions are different and distinct from each other.

Posterior calcaneal spur:

Posterior calcaneal spurs form on the back of the heel and often are associated with a condition called insertional Achilles tendonitis, which involves inflammation of the Achilles tendon. The bone spur in this case grows gradually surrounding the part of the tendon where it is inserted into the heel bone.

What causes heel spurs?

The exact cause of heel spurs has been difficult to determine. Initially, it was thought that plantar heel spurs developed as a result of repetitive traction of the plantar fascia’s insertion into the calcaneus bone, leading to inflammation and subsequent bone formation. (2) However, this theory was challenged by other scientists proposing that traction is the cause of the posterior/ Achilles spurs and not the plantar ones, as when traction happens around the Achilles tendon, posterior spurs always form within the tendon, while in the case of plantar spurs, almost half of them are not formed within the plantar fascia, which suggests other reasons are involved. One of these reasons is vertical compression since the bony protrusion is often vertically oriented and that plantar spurs are associated much more with excess weight or long periods of standing, while posterior spurs are more common with sustained activities. (3)

Some believe that the natural process of aging also has a hand in developing heel spurs, in addition to the higher tendency for older individuals to have calcium deposits forming excess small bony parts, aging itself can cause stiffness of the heel pad and decrease its ability to soften the force endured during impacts, leading to repetitive stress and microtrauma which eventually contribute to the bony development. (4)

Finally, genetics may also well play a role in developing heel spurs; some people have a genetic predisposition for new bone formation responding to a certain level of mechanical stressors, which explains why other people don’t develop spurs even when subjected to the same or greater level of mechanical stress. (5)

What Are the Risk Factors of Heel Spurs?

  1. Foot position and structural issues: the structure of the feet and how this affects where your feet land when touching the ground, and the dynamics of your gait, play a role in developing heel spurs. For example, when your feet roll towards the inside when you walk, transferring your body’s weight to the inner edge instead of the ball of the foot, this is called overpronation of the feet and has been significantly associated with the formation of plantar heel spurs. Having flat or high arched feet have also been linked to the development of heel spurs.
  2. Obesity: a study found that 82% of those with plantar heel spurs are either overweight or obese (6), another study reported that those with plantar heel spurs are about 7 times more likely to be obese when compared to those who don’t have the condition. (4)
  3. Older age: the incidence of heel spurs increases greatly with age, on average about 55% of those above 62 years old may have some form of heel spurs, it was also found that 98.4% of those who have plantar heel spurs are above the age of 40. Degenerative changes and alteration of the gait patterns with old age are thought to contribute to this high prevalence.
  4. Rheumatoid disorders: plantar heel spurs are commonly found in any rheumatology-related disorder. Those with plantar heel spurs when compared to those who don’t, were found to be 3 to 10 times more likely to have one area in their body that exhibits osteoarthritis.
  5. Being female: studies have found that generally in older age the incidence of developing heel spurs is similar between females and males, while in younger populations, up to 49 years of age, females were found to have a much higher incidence than males, which was theorized to be as a result of wearing high heels that can alter the normal feet biomechanics. (7)
  6. Plantar fasciitis: there is a strong statistical association between having plantar fasciitis and developing heel spurs; in fact, plantar heel spurs are present in 45% to 85% of those who have plantar fasciitis, this is thought to be due to both of these conditions sharing similar risk factors, and that the impact of plantar fasciitis on the feet can and indirectly contribute to the formation of plantar heel spurs.
  7. Certain physical activities that increase the load and impact on the feet such as running, jogging, and jumping.
  8. Inappropriate footwear: poorly fitted shoes can change how a person walks and puts pressure on more areas than others. Old worn-out shoes, high heels, or shoes without enough cushioning can all negatively affect the feet due to the lack of shock absorption or padding, which reduces the impact of high vertical loading on the feet.
  9. Diabetes: although it is not fully established as a risk factor for developing heel spurs, some studies have found links between the two. For example, a study has reported that those who have plantar heel spurs are 4 times more likely to also have diabetes. (6)
  10. Trauma to the heel can also contribute to the formation of heel spurs.

What are the symptoms of heel spurs?

How do you know if you have a heel spur? Actually, in a large number of cases, heel spurs can be asymptomatic, however, when symptoms are present, heel spurs can be very painful and a cause of discomfort. Heel spur pain is often due to the contact of the spur with the surrounding tissues, leading to friction and inflammation.

The pain associated with heel spurs can be acute, intermittent, or chronic, and it is exacerbated during high-impact or weight-bearing activities such as walking, jogging, or running. It is usually described as stabbing or sharp pain that occurs particularly when taking the first steps in the morning and may continue in a duller form throughout the rest of the day. Swelling and skin warmth around the heel may also happen, and tenderness of a specific area can be felt when pressed against with hands or when the feet come in direct contact with hard surfaces. In some cases, the small bony protrusion can be felt or even seen under the heel. If your symptoms resemble those mentioned, then you may have a heel spur, however, an accurate diagnosis by a physician is very important as other heel conditions may also share some of these symptoms.

How are heel spurs diagnosed?

To get a confirmed diagnosis with heel spurs or just get to the bottom of addressing the cause and management of your symptoms, you should book an appointment with your general practitioner for an initial consultation, or book directly with a specialist such as a podiatrist or an orthopedic doctor. Your doctor will ask you about the history of your pain, your medical and occupational history so they will be able to determine if you have any risk factors. Your doctor then will proceed to examine your feet, checking for tenderness, redness, or swelling, also checking for any deformities or structural issues, and ask you to walk to observe your gait or stand on one foot at a time to see how you carry your body weight.

Your doctor might be able to feel or see the bony protrusion, however, it is not common for heel spurs to be visible, hence, he/she will probably then ask for an X-ray to confirm the heel spur diagnosis and ensure that no other issue is the cause behind your symptoms.

How are heel spurs treated?

Treatment for heel spurs is categorized into the following:

Conservative heel spur treatments including:

Rest: this is vital in the management and treatment of the symptoms of both heel spurs and plantar fasciitis if coexist. As we mentioned earlier, vertical weight compression is thought to be the main cause behind developing heel spurs, so resting and lifting the weight of your body from your feet can help to stop the pain and assist in faster recovery, as it will allow the natural process of healing to take place without more activities that can cause further damage. If it is not possible for you to completely rest, then activity modification is required, for example, try to use transportation instead of walking, stop any high-impact exercise, and exchange that with seated exercises. If your job requires a long period of standing, make sure to wear appropriate cushioned shoes while taking regular breaks to sit down.

Icing: cold compressions for 15 minutes can help relieve the pain and reduce the symptoms of inflammation. You can apply the ice by submerging your feet in an ice bath or using an icepack. Alternatively, you can try Heel That Pain Ice Therapy Slippers, which allow you to strap them into your feet, so you get full coverage while being secured in place. Heel That Pain slippers ensure the entire bottom surface of your feet is properly iced, reducing pain, tenderness, and swelling.

Over-the-counter medications: OTC medications can help you manage the pain, particularly non-steroidal anti-inflammatory drugs such as Ibuprofen and Voltaren, as in addition to being analgesics and relieving the pain, they also target the inflammation which can help speed up the process of recovery.

Corticosteroid injections: if the pain is severe, your doctor may suggest injections of corticosteroids into your foot, this is usually done under local anesthesia, however, it is important to note that corticosteroid injections are usually used as a primary line of treatment only for severe cases, or otherwise reserved as an advance treatment for those who do not improve after a couple of months of applying conservative treatments, this is due to the possible negative side effects of corticosteroid injection including fat pad atrophy and rupture of the plantar fascia.

Orthotics: shoe inserts are important in the management of heel spur symptoms, as they can decrease the magnitude of the weight-bearing load on the heel, they can do so by increasing the height of the shoes which provides more cushioning between the heel and the ground. It was also found that softer and thicker appropriately sized orthotics can decrease the weight load on the calcaneus bone even further, which helps to greatly reduce the pain associated with heel spurs. (8)

A clinical study indicated that 10/16 of its participants who suffered from calcaneal spurs have reported a 70-100% decrease in their pain after using thick orthotics increasing the heel height and reducing the impact during weight-bearing daily activities. (9)

Orthotics also can play a significant role in treating plantar fasciitis that often coexists with heel spurs, a systematic review study of 19 clinical trials that included 1660 participants, reported that foot orthotics have been shown to reduce plantar heel pain in adults who have used them for a duration of (7-12) weeks. (10) Another clinical trial even found that orthotics can be noticeably better than the use of non-steroidal anti-inflammatory medications, heel cups, or corticosteroid injections. (11)

You can try either over-the-counter orthotics or get them custom-made to your foot size and shape. However, custom-made orthotics are usually expensive, ranging from 100-400 USD, and in real-life use, studies have shown that prefabricated OTC orthotics are usually as effective as the custom-made ones in treating heel pain.

That being said, using any OTC heel pad that is not designed for treating your foot condition will not produce great results as these heel pads are not made to provide structural support, and often just capable of mild shock absorption. Heel That Pain offers Heel Seats foot orthotics which use a unique and revolutionary technology called fascia-bar, which has been found, through a clinical trial conducted by the University of Iowa, to be 2 times more effective in relieving heel pain when compared to other leading orthotics brands. This is due to its amazing dense and soft Kraton cushion that has significant shock absorption ability, in addition to providing extensive support to both your heel and plantar fascia during weight-bearing activities, reducing the pain from plantar fasciitis and heel spurs, and accelerating your recovery, all with a very affordable cost.

Another great well-designed product that is also offered by Heel That Pain is the Heel Seat Wraps, which are made to provide you with all the benefits of the Heel Seat shoe orthotics but with the ability to wear them barefoot, with sandals, slippers, or any kind of footwear. They are extremely supportive, soft on your feet, and flexible, with non-slip bottom that ensures your safety even when walking on slick floor or stairs. These heel wraps are great to maximize your treatment and speed up your recovery by wearing orthotics indoors and outdoors without putting on shoes at home.

Stretching exercises: there are many stretching exercises that you can perform to warm up your plantar fascia, stretch the surrounding muscles and reduce the pain. These exercises include calf stretches, foot flexion, Achilles tendon, and plantar fascia stretches, they can be done with the help of a physical therapist or you can learn to do them yourself at home.

Strapping/ taping of the foot: athletic or kinesiology tape can be used to provide arch support and stabilize the structure of the foot. Try these taping methods to support your feet during activity.

Shoe change: high heels shoes, ill-fitted shoes or inappropriate ones can impact the way you bear your weight on your feet, contributing to the development of heel spurs, and if not corrected, this will aggravate your symptoms even further. Hence, it is necessary to pay attention to your footwear, ensuring that they are the accurate size, suitable for the activities you perform, and dense cushioning to provide shock absorption. If you are an active person who performs any form of high-impact exercises for long periods, changing your sports shoes every few months or replacing the insoles with shoe inserts can be necessary.

Advanced medical heel spur treatments including:

Botulinum toxin injection: this is occasionally used as an alternative for corticosteroid injections, particularly when heel spurs are accompanied by a plantar fasciitis diagnosis. This treatment has fewer side effects than corticosteroid injections, and it helps to reduce the pain associated with heel spurs and plantar fasciitis while improving overall foot functions.

Radiation therapy: ionizing radiation has an anti-inflammatory effect on various types of cells, several studies have reported its efficacy in treating the symptoms resulting from heel spurs, (12,13). One clinical trial has reported that the use of low doses of radiotherapy resulted in great pain reduction that persisted for years, with no signs of acute or late toxicity as a result of using the radiation therapy, suggesting that this is a cheap, simple, and safe technique to apply in the treatment of heel spurs. (14)

Iontophoresis and phonophoresis: these procedures are used to help a topical medication, corticosteroid in this case, deep into the soft tissues. Iontophoresis uses ionic forces (electric current) to deliver the medicine, while phonophoresis uses the thermal effect produced by ultrasound waves. Both procedures are similarly effective and greatly reduce the symptoms associated with both plantar fasciitis and heel spurs. However, these treatments are required to be done 2 to 3 times per week, which makes them less practical and cost-effective for regular people, hence they are often prescribed in the process of treating athletes who have the need and resources to do so.

Ultrasound therapy: using certain doses of ultrasound has a therapeutic and analgesic effect in treating heel spurs’ pain. It was found that the dose of 0.8 W/cm2 was capable of reducing pain by 34% after 5 sessions, by 50% after 10 sessions, and by 71% 4 weeks after the completion of therapy. However, this treatment requires multiple sessions per week so it can be time-consuming.

Extracorporeal shock-wave therapy (ESWT): this is a non-invasive treatment utilizing the delivery of high-pressure shock waves to the soft tissues in the affected area, significantly reducing pain and inflammation. This is thought to be due to its ability to stimulate the blood flow which increases the immune response and the healing process, additionally, it can shut down the pain neuronal pathways in the affected area, and help in the regeneration of the healthy tissues. A study investigating the effectiveness of ESWT in treating heel spurs has reported that after administering one session weekly for 5 weeks, 66.7% of all participants have reported excellent results with no more painful experiences, while the pain was reduced by 50% in 15.7% of the cases, and only 17.6% of participants had no satisfactory results. (15)

Another study compared the effectiveness of ESWT to ultrasound therapy in treating heel spurs symptoms, the study concluded that while both techniques significantly reduce pain, much fewer ESWT sessions were needed to produce the same results as ultrasound, which suggests that ESWT is more effective than ultrasound therapy. (16)

Surgery: this is reserved as a last option of treatment if all other conservative treatments have failed after following for 6 months to a year, and the less invasive procedures have also been considered without success. There are various approaches of surgery that are used in the treatment of heel spurs, they involve either removal of the spur only, focus on the release of the plantar fascia without the removal of the spur, or removing the spur and releasing the fascia at the same time. The surgery often has a high success rate, however, all surgeries come with possible short and long-term complications that should be taken into account before considering this option. More advanced techniques have been developed in recent years to minimize the recovery time from the surgery and the possible side effects, including endoscopic plantar fasciotomy and percutaneous release of the plantar fascia.

Addressing heel spur myths

Many myths surround the topic of heels spurs, therefore, it is important to educate yourself about this condition and be able to separate facts from fiction.

Can heel spurs break through the foot skin?

The answer to this question is no, it is a myth that heel spurs can get so long that they can penetrate the skin, and although they can get sometimes to a point where they can be felt or become visible underneath the foot, they can’t pierce through the skin.

Can you dissolve a heel spur?

Well, the answer to this question is unclear as there is no scientific evidence that supports this theory, and despite heel bone spurs being a build-up of calcium deposits, no exact substance or vitamin has been shown with certainty to dissolve these bone protrusions. Hence, it is important to stick to evidence-based science when it comes to the prevention and treatment of heel spurs.

How do you break a heel spur?

As mentioned earlier, heel spurs can be removed surgically by a medically trained specialist, so please do not attempt to break your heel spurs a this can be very dangerous and have serious complications. Heel spurs can rarely break on their own though, they then get lodged into the surrounding soft tissue, which can lead to an increase in the intensity of symptoms.

Can heel spurs cause back or hip pain?

Back pain or hip pain is not typical symptoms of heel spurs; however, some indirect correlation can exist as a result of long-term untreated heel spurs that can then impact the way the person carries their weight on their feet, leading to a change in their gait, putting more pressure on certain parts or joints in their body to compensate for the person’s inability to put on all their body weight on their struggling foot, this will consequently lead to pain in their lower back or hip joints.

What is the prognosis of heel bone spurs?

Although heel spurs can cause a lot of pain and discomfort when they are symptomatic, 80% to 90% of cases will greatly improve or completely recover from the symptoms, through following conservative treatments. The improvement can happen within a few weeks to months; hence it is important to stick properly to the conservative treatment and allow your feet time to heel. For those who do not improve or get worse after following the conservative and treatment for 6 months to a year, surgery may be needed to relieve the symptoms and restore the full function of the foot.

How to prevent heel spurs

  1. Maintain a healthy weight.
  2. Wear appropriate shoes for the activity you are performing.
  3. Ensure your shoes is well-fitted and that they have great heel and arch support using dense and soft materials to cushion the bottom of your feet and provide shock absorption and structural support.
  4. Try to avoid intense prolonged high-impact activities.
  5. Always take breaks when standing for too long to alleviate the vertical pressure on your feet.
  6. If you experience any pain in the bottom of your feet, stop doing the activity immediately and rest, as pushing through the pain will only aid in the developing or worsening of any heel condition.


Heel Spurs

A heel spur is an outgrowth of bone, known as a bone spur or osteophyte, on the heel of the foot. Bone spurs form as the body attempts to repair damage caused by constant physical irritation, pressure or stress, and may form in various regions of the body. They develop in the heel for a variety of reasons. In many cases, the long ligament that runs across the bottom of the foot, called the plantar fascia, gets pulled too tightly and an inflammation known as plantar fasciitis results. As the body tries to repair the damage, a heel spur may form.

Causes of Heel Spurs

Plantar fasciitis is the most common reason for a heel spur to develop, but there are many other possible contributing factors. Normal aging causes cartilage and ligaments to wear down and bones to rub together and the body may create a bone spur in response. Activities like dancing, running and jumping can exacerbate the irritation, as can being overweight or wearing ill-fitting or high-heeled shoes. Having flat feet, naturally tight calves or very high arches, or standing or walking for prolonged periods also puts individuals at greater risk for developing heel spurs.

Symptoms of Heel Spurs

A patient with heel spurs experiences sharp heel pain when weight is put on the affected foot. Pain may also be felt along the arch of the foot or on the back of the leg during walking. The pain is most intense when the patient stands after sitting or lying for an extended period. Severe pain upon arising after sleep is a frequent complaint. While it is the plantar fasciitis, not the heel spur, that is usually causing the pain, the heel spur, which can be seen on X-ray, demonstrates that the foot damage is of relatively long-standing.

Treatment of Heel Spurs

Treatments for plantar fasciitis and heel spurs begin with rest, stretching exercises and anti-inflammatory medications, such as ibuprofen, to alleviate pain. Corticosteroid injections at the site may be administered as well. Certain lifestyle adjustments, such as weight loss and wearing well-fitted shoes and appropriate orthotics, may help to keep the condition from becoming chronic. When these conservative methods do not provide relief, extracorporeal shock wave therapy at the site, or night splints to stretch the calf and arch during sleep, may be considered. In severe cases heel spurs may necessitate surgery.

Additional Resources

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Phone: 902-429-1416

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Brendan Bennett


Brendan Bennett: Podiatrist. BSc (Hons) Pod. FFPM RCPS (Glasg). FC Pod Med
Graduate of:
Wales Center for Podiatric Studies; University of Wales.

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Rebecca Bennett


Rebecca Bennett: Podiatrist BSc (Hons) Pod BSN. MCP

Graduate of:

Wales Center for Podiatric Studies: University of Wales.

University of Pittsburgh: BSN

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Rebecca Bennett is a member

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Nicole Beatty


Nicole Beatty Podiatrist. Dip Pod Med.

Graduate of:

Mitchener Institute Toronto Ontario.


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Nicole Beatty is a member of the following professional organizations:

Nova Scotia Pod

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7 Common Traits Among People Who Develop Heel Spurs: Achilles Foot Care: Podiatrists

If you have a bone spur, then a portion of a ligament has calcified (hardened) in an effort to better distribute and support your weight. When this bone spur occurs on the heel, it’s called a heel spur, and because even a relatively light person puts a lot of weight on this part of the body in any given day, the result can be very painful.  

People who develop bone spurs often have a lot in common, and what they have in common may be exactly what you need to know in order to prevent and get relief for your bone spurs. Let’s explore seven traits common among those with this condition.

1. Abnormal gait

Do you have an abnormal gait or different way of walking because of a past injury, aging, birth abnormality, or pain in another part of your foot? This misalignment puts extra and uneven pressure on parts of the foot that would normally not experience such pressure, and this may lead to heel spurs for which you need heel spur treatment.

2. Running on hard surfaces

Sidewalks and streets may give you a more even terrain on which to run or walk, but many people who develop bone spurs often run, walk, or stand on hard surfaces like these, creating additional pressure on the heel as well as the surrounding soft tissue with each impact.

If you run frequently or stand for long periods of time on a hard surface, wear proper shoes and replace them often, which leads us to our next trait.

3.  Poor footwear choices

Yet another common trait that you’ll find among people with bone spurs is the fact that they either don’t invest in good shoes or don’t realize the importance of replacing worn-out pairs. Whether they do it because they value fashion over foot health or they’re living a very thrifty lifestyle, these individuals may develop heel spurs. Choose shoes with good arch support and don’t wear your shoes ragged — you’re not doing yourself any favors.

4. Being overweight or obese

One in three Americans is overweight or obese, according to the U.S. Department of Health. Being even a little overweight can put undue stress on the heels, leading to the build-up of calcium deposits associated with heel spurs. If you are obese and have diabetes, then this may make matters worse as diabetes is often associated with calcification throughout the body, including the foot.

5. Have plantar fasciitis

Your plantar fascia is a thin, long ligament that rests immediately below the skin on the bottom of your foot. This fibrous tissue connects the heel to the front of the foot and supports your arches. Foot arches absorb impact by slowly collapsing when you put your foot down and concaving when you lift the foot. This helps distribute weight evenly across the foot. Too much stress on the bottom of the foot causes inflammation, stiffness, and pain of this ligament and a collapsing of the arches, which may lead to or accompany heel spurs.

6. New to exercise

If you’re a generally sedentary person who has just made that very important decision to get in shape, you may suddenly be putting a lot of pressure on your feet that they aren’t used to, especially if you’re overweight. If you start experiencing foot pain when you begin a new workout regimen, you should schedule an appointment with Achilles Foot Care soon because the sooner you get it treated the faster you can get back to meeting your fitness goals.

7. Have no pain

According to the American Academy of Orthopaedic Surgeons, a surprisingly large number of people develop bone spurs in their lifetime, as many as 10% of the population. A tiny percentage of these individuals, only around 5%, have pain, so if you have heel spurs without pain, you may not need to remove them, but chances are that because you’re reading this article, you’re one of the “lucky” ones who do experience pain from your heel spurs, in which case, Dr. Roberto can help you find relief through non-surgical treatment options.

If you’re experiencing pain in your heel and middle of your foot, don’t wait to get a proper diagnosis and seek treatment. Book online today.

Heel Spur Surgery | Northwest Surgery Center

A heel spur is a buildup of calcium that deposits on the bottom of the heel bone.  It may occur on its own or may be related to another health condition. Below are the causes, symptoms and remedies of heel spurs.

Possible Causes of Heel Spurs

  • Heel bruising
  • Running and jumping on hard surfaces
  • Age
  • Improper footwear
  • Athletic activity
  • Being overweight
  • Diabetes
  • Female factor
  • Improper gait
  • Plantar fasciitis

Heel spurs occur because of a calcium deposit on the underside of the heel bone. They take months to form.

When shoes wear out, they do not properly bear your body weight, which may cause heel spurs to develop. Other causes include reactive arthritis and back pain also known as ankylosing spondylitis.

Symptoms of a Heel Spur

  • Shooting pain in the heel when you stand up in the morning
  • Swollen Heel
  • Dull pain in the heel that lasts through the day
  • Small bone protrusion visible in the heel

Often, heel spurs don’t show any symptoms. There may not be noticeable changes in the bones and tissues around your heel. Over time, however, a bony spur will appear.

In many cases, a heel spur is painless. However, if it is linked to plantar fasciitis, it will probably hurt. You might have pain in the front part of the heel and that area might feel warm to the touch. The arch of the foot might also be affected by this condition.

If you have any of the above, your feet should be properly diagnosed by a qualified professional.

Diagnosis of Heel Spurs

Definitive diagnosis of heel spurs can be done only with x-rays.  Though the symptoms might be obvious, detecting the heel spur on your own is difficult.  Only a qualified professional such as an orthopedic surgeon can tell for sure if you have a heel spur.

Non-Surgical Heel Spur Treatment Options

  1. Apply ice: Ice the bottoms of your feet. This helps relieve pain and reduce inflammation.
  2. Wear cushioned shoes or inserts: The less hard pounding your feet endure, the better.
  3. Physical therapy: Specific stretching exercises and movements might temporarilly reduce heel spur pain.  They should be prescribed only by a qualified, professional physical therapist.
  4. Rest: Not using your feet or limiting the time on your feet might be the best non-surgical remedy to heel spurs.
  5. Anti-inflammatory medication: Ibuprophen is a common over-the-counter pill taken to reduce swelling. Cortisone or steroids might be prescribed by a qualified professional.
  6. Pain medication: Aspirin, acetaminophen and other over-the-counter pain medications can help to temporarilly reduce the pain caused by heel spurs.  Check with a qualified professional before taking any medication.

Surgical Treatment for Heel Spurs

Considering today’s minimally invasive foot surgery techniques, removing a heel spur is a viable option that offers minimal pain and recovery time.  Minimally invasive heel spur surgery removes the calcium deposit. If necessary, the surgeon may also release the plantar fascia muscle. Consult with a minimally invasive surgery center like Northwest Surgery Center for a free diagnosis of your foot condition.

90,000 Heel spur – causes, symptoms of the disease, diagnosis and treatment


The information in this section cannot be used for self-diagnosis and self-medication. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For a diagnosis and correct prescription of treatment, you should contact your doctor.

Heel spur: causes, symptoms, diagnosis and treatment.


Heel spur, or plantar fasciitis, refers to a disease of the feet with characteristic chronic aseptic (without a bacterial agent) inflammation in the area of ​​attachment of the large ligament on the sole of the foot (plantar aponeurosis, or fascia) to the heel bone. Plantar fasciitis usually develops on the posterior or inferior surface of the calcaneus, resembling a spur, which is why it is named.

Reasons for the appearance of a heel spur

The plantar fascia is a bundle of fibers that connects the calcaneal tuberosity to the phalanges of the fingers.It helps 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 acts as a shock absorber (bridge) for the arch of the foot.

One of the modern theories explaining the formation of heel spur syndrome is that inflammation is caused by chronic microtraumatization of the aponeurosis during its stretching.

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 multiple ruptures, inflammation and shortening of the fibers of the plantar aponeurosis occurs, they lose their elasticity. Pathological feedback is turned on: the more micro-ruptures, the stronger the inflammation, the shorter the ligaments, the more frequent the micro-ruptures. 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 heel bone. The next stage is the formation of osteophytes on the calcaneus, which are called “heel spur”.Thus, the growth on the calcaneus itself is only the body’s response to inflammation, but not the root cause of pain.

Predisposing factors for the development of spurs are flat feet, overweight, excessive foot overload, 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 prolonged standing, with prolonged walking on a hard surface, and the frequent carrying of weights.

A heel spur is more common in women over the age of 40-45.

This may be 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 the plantar fascia is overstretched.

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 and bilateral, that is, on the feet of one or both legs.

Symptoms of the heel spur

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 located deep, directly in front of the heel and more often on the inside of the heel;
  • Pain is more acute in the morning and at the end of a tiring day;
  • 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;
  • Incorrect rotation of the foot, clubfoot.

Pain occurs in the central and medial parts of the plantar surface of the calcaneal region during palpation, when pressing on the tubercle of the calcaneus, when squeezing the heel on both sides. Extending the thumb can also cause increased pain in the heel area.

With a posterior calcaneal spur, soreness is observed at the place of attachment of the Achilles tendon when walking and pressure from 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 have severe complaints, although there is no sign of spurs on radiographs.

Diagnostics of the heel spur

Evaluation of patients with heel pain begins with an assessment of general health (including history of treatment for heel pain), occupational activity, hobbies, weight changes, or if symptom onset coincides with increased physical activity.

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

  • Radiography of the calcaneal region is necessary to exclude a fracture if there is evidence of injury in the anamnesis. In the early stages of formation, the heel spur is not visualized on the roentgenogram.

Additional examination methods include:

  • general and biochemical blood tests to identify the inflammatory process, assess the level of uric acid;

Which doctors to contact

Traumatologists-orthopedists, surgeons are engaged in 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.

Method of unloading the foot .The most effective treatment is to return the foot to the correct position when walking, restore the arch of the longitudinal arches and reduce the pressure on the heel area. It is considered rational to wear orthopedic shoes, which 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, which make physiological positioning of the foot possible.

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

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

The tension in the calf muscles aggravates the course of the disease and increases the 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.


  • electrophoresis with hyaluronidase or 5% calcium chloride solution: the introduction of drugs into the tissue by means of an electric current;
  • sonophoresis with hydrocortisone: treatment of tissues with ultrasonic waves that improve the penetration of drugs;
  • ultrasound therapy: warming up tissues and reducing inflammatory reactions using ultrasound waves;
  • magnetic therapy;
  • mud and mineral baths;
  • laser therapy: heating of deep tissue layers with a laser promotes local improvement of blood flow.

Shockwave therapy is a non-invasive method of treatment that allows you to quickly reduce or completely remove pain syndrome. The technique is based on the action 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 cellular ion exchange is restored, thereby providing anti-inflammatory and anti-edema effects.

Physiotherapy 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 syndrome associated with reflex muscle spasm.

Physiotherapy exercises 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 recurrence.

Surgical treatment
. It is possible to get rid of a large heel spur only with a surgical method. When choosing the classic variant of the operation, the surgeon cuts the fascia completely and removes the bony protrusion. A more modern and gentle technique is radiofrequency microtenotomy. The essence of the operation is to eliminate damaged tissue using radio frequency waves.

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

In difficult cases, characterized by a long and recurrent course, surgical treatment is a non-alternative method.


The main complication of a heel spur 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 resting 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 severe pain syndrome, posture asymmetry 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 physical activity.

Other complications, such as detachment of the fascia from the attachment site and suppuration, are rare.

Prevention of heel spur

The development of a heel spur can be prevented in most cases.It is recommended to provide regular rest for the feet in combination with correct exercises, take breaks for warm-up in 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 adhere to the foot over the entire area – they allow you to restore the normal height of the arch of the foot in the first weeks of constant wearing and, thus, reduce the tension of the plantar fascia.

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


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

The information in this section cannot be used for self-diagnosis and self-medication. In case of pain or other exacerbation of the disease, only the attending physician should prescribe diagnostic tests. For a diagnosis and correct prescription of treatment, you should contact your doctor.

Calcaneal spur – symptoms, diagnosis, treatment at the Central Clinical Hospital of the Russian Academy of Sciences

“Heel spur”, plantar fasciitis, inflammation of the plantar aponeurosis, tendoperiostopathy of the plantar aponeurosis – this is the name of the inflammation at the site of attachment of the plantar aponeurosis to the calcaneus.

The causes of are: longitudinal-transverse flat feet, overweight, increased physical activity, metabolic disorders, impaired blood supply, irrational footwear.

Typical signs of disease are sharp local pain in the heel, which can spread further down the entire foot.

The most common diagnostic method , in addition to analyzing patient complaints, is an X-ray of the foot, performed in the lateral projection, in which an osteophyte (“spike”) can be seen in the region of the medial process of the calcaneus tuberosity.However, the presence or absence of a thorn does not determine the sensation of pain in the heel area.

Therefore, the most informative research method for reliable diagnosis of the “heel spur” is magnetic resonance imaging (MRI) of the foot , which allows to assess the degree of soft tissue inflammation at the site of attachment of the plantar aponeurosis to the heel bone.

Treatment of heel spurs is performed on an outpatient basis.

The basic methods of treatment are:

  1. X-ray therapy.
  2. Steroid blockade – the introduction of prolonged hormones into the area of ​​attachment of the plantar aponeurosis.
  3. Timely use of non-steroidal anti-inflammatory drugs.
  4. Regular wearing of insoles-instep supports as a method of prevention and consolidation of the achieved results.

These methods can be used both independently and in combination with each other.
However, the main and most effective method of treating heel pain is currently extracorporeal shock wave therapy – a local method of exposure to pneumatic and electromagnetic waves.

In the Central Clinical Hospital of the Russian Academy of Sciences extracorporeal shock wave therapy has been used for about 10 years. Our doctors were trained at the leading clinics in Europe and have certificates of the European ATRAD society.

The use of the method of extracorporeal shock wave therapy allows to obtain positive dynamics in the treatment of “heel spurs” immediately after the procedure.

The procedure of extracorporeal shock wave therapy is non-invasive, it is an alternative to treatment with prolonged hormones, which is extremely important for people suffering from endocrine diseases (diabetes mellitus, etc.).and diseases of the cardiovascular system, as well as athletes who are tested for doping.

We will be happy to help you too.

90,000 Heel spur: diagnosis and treatment

Calcaneal spur or plantar fasciitis is an overgrowth of bone tissue in the area of ​​the calcaneus tuberosity. According to statistics, the disease is more common in women over 40, and in old age every fourth person suffers from a heel spur.

Causes of the formation of a heel spur

When walking, it is on the heel fascia that the entire main load falls, this explains the high prevalence of the disease, especially in old age.

Other causes of a heel spur include:

  • Injuries (sprains, dislocations, bruises, fractures)
  • Metabolic disorders
  • Excess weight
  • Diabetes mellitus
  • Excessive physical activity in athletes
  • Frequent wearing of high-heeled shoes or, on the contrary, without them at all
  • Diseases of the joints and connective tissue (gout, arthritis, ankylosing spondylitis, etc.)
  • Longitudinal flat feet
  • Age changes

Heel spur symptoms

At the initial stages of the development of the disease, it does not manifest itself in any way and can be practically asymptomatic. As the inflammatory process progresses and the bone spike grows, the patient may experience complaints:

  • Pain while walking or exercising. Gradually, unpleasant sensations begin to appear with any, even the slightest load on the injured heel.
  • According to the descriptions of patients, the pain resembles the sensation of a nail or a needle in the heel, it is acute in nature and depends on the degree of growth of the bone spine.
  • Sharp pain after a night’s rest. As the person moves, it gradually dies down.
  • Over time, scar tissue forms around the heel spur, in which calcium salts are deposited and bone spines-osteophytes begin to grow. This is manifested by the appearance of pain at rest.
  • As the disease progresses, the patient’s gait changes.This is due to the fact that he is trying to spare the injured leg and reduce the load on it. The constant transfer of body weight from the heel to the other part of the foot can lead to the formation of transverse flat feet. Thus, a heel spur can significantly impair normal life activity and become a serious obstacle to work and sports.
  • Outwardly, the disease has no pronounced manifestations, sometimes a slight swelling of the heel and the appearance of calluses can be observed.

Diagnosis of the heel spur

Diagnosis of the disease, as a rule, does not cause difficulties.In order to suspect a heel spur, it is enough for the doctor to evaluate the patient’s complaints: pain in the heel area, especially after a night’s sleep and physical exertion.
On examination, the orthopedist palpates the patient’s foot and assesses the localization and severity of the pain syndrome.
To confirm the diagnosis, instrumental examinations are prescribed, first of all – radiography.
In the images, the doctor can estimate the size and location of the thorn. In the early stages of the development of the disease, the formation has a rounded shape, gradually it takes the form of a bird’s beak and can exceed the size of 1 cm.
In severe cases, an orthopedist prescribes an MRI to assess the condition of the soft tissue around the heel spur.
Ultrasound is not an informative and necessary method for diagnosing a heel spur, but it is used to monitor the course and result of treatment.

Heel spur treatment

Complex treatment of a heel spur consists of several points: reducing the load on the foot, drug treatment and instrumental therapy

Reduction of physical activity on the foot includes:

  • Half-bed rest during acute periods of the disease
  • Reduction in walking and standing time, frequent rest breaks during walks, mandatory use of special insoles
  • Individually selected complex of physiotherapy exercises with obligatory taping, that is, fixation of the heel fascia with a special sports tape-plaster
  • Use of orthoses at night – special devices that hold the leg in a position at a right angle. This avoids significantly reducing or eliminating the symptom of morning pain
  • Use of orthopedic insoles and, if necessary, special devices in the form of a cane or crutches when walking

Drug treatment

A short course of non-steroidal anti-inflammatory drugs (NSAIDs) may be prescribed to reduce inflammation and pain externally and internally. Long-term therapy is fraught with complications from the gastrointestinal tract.With severe inflammation and severe pain, local injections of glucocorticoid hormones may be prescribed.
In the absence of the effect of such treatment, drug blockades are prescribed to reduce or completely relieve pain. The drug is injected directly into the affected area, which allows you to achieve a good result. However, it is important that the procedure is performed by an experienced and competent orthopedist. Otherwise, there is a risk of complications.
Physiotherapy is prescribed in combination with medications. With a heel spur, the following are used: magnetotherapy, electrophoresis, paraffin applications, mud and radon baths.

Surgical treatment

If conservative methods do not help get rid of the problem, then it is necessary to resort to surgical treatment. During the operation, an incision is made in the area of ​​the spur, the existing growth is removed, and the tissues are sutured.
Endoscopic dissection of the fascia is currently the most common surgical procedure.Through a small incision, the doctor inserts a special device – an endoscope, with which he dissects the fascia and removes the spur. The procedure is often done under X-ray control to minimize complications and maximize the effect of the surgery.
Instrumental methods have proven to be effective in the treatment of heel spurs.

Shockwave therapy

At the heart of the treatment, as the name implies, is the impact on the heel spur with special shock acoustic low-frequency waves.They reduce soreness, destroy calcifications, stimulate metabolism and eliminate inflammation.
The procedure takes no more than half an hour and is performed once every few days. The full course of treatment is 5-7 sessions.
The advantages of shock wave therapy for the heel spur are the absence of unpleasant sensations during the procedure, high efficiency and gradual destruction of the “salt deposits” areas.
The procedure is contraindicated in adolescents under 18 years of age, pregnant women, patients with thrombophlebitis, acute infectious diseases and low blood pressure.

Laser treatment

The action of the laser helps to reduce swelling, pain and inflammation. However, this treatment is symptomatic and does not address the underlying cause of the disease.
The advantages of this therapy are good, long lasting effect, no side effects and no risk of allergies.
Contraindications are thyrotoxicosis, neoplasms, diabetes mellitus and severe diseases of internal organs.

Ultrasound treatment

Exposure to ultrasound can not only relieve pain and inflammation, but also break up areas of salt deposits.
The advantages of the procedure are the absence of pain and discomfort during treatment, the combination of the elimination of symptoms and the root cause of the disease.
Contraindications to ultrasound treatment of heel spurs are: lowering blood pressure, pregnancy, cardiovascular disease and neurological disorders.

X-ray therapy of the heel spur

This treatment option exposes the heel spur to X-rays. The procedure allows you to block nerve endings, which in turn helps to eliminate pain.
The advantages of the method include painlessness and short duration of the session, as well as a combination of analgesic and anti-inflammatory effects.
Among the contraindications to the procedure are: pregnancy and breastfeeding, exhaustion, blood diseases, severe pathologies of internal organs.


Cryodestruction, that is, exposure to liquid nitrogen, is an external procedure and allows you to remove spikes on the heel.
Cryodestruction can cause discomfort, but does not leave behind scars and prevents recurrent exacerbation of the disease.

When should I see a doctor?

If pain in the heel occurs during exercise or after sleep, it is better not to delay a visit to the doctor. Experienced orthopedists of the Stolitsa network of clinics will conduct a quick examination, diagnose and select a comprehensive therapy that will allow you to forget about pain and gait disturbances forever.

90,000 Diagnosis and treatment of heel spurs.Shock wave therapy.

Do you belong to a large group of people who experience heel pain throughout the day? The most common cause of this pain is the notorious heel spur. The pain occurs under the arch of the foot, on the inner surface of the foot, and only in the front of the heel bone. You can test this for yourself – while sitting, bend your big toe in relation to you and follow the line from the toe, probing the foot towards the heel to the heel bone. If you have a spur, you will clearly find the point of pain.

Treatment of heel spur (plantar fasciitis) with shock wave therapy


The pain usually occurs during the first steps after waking up or if you have been sitting for a long time, and then after you “disperse” the pain dulls and goes away. The heel itself does not necessarily hurt, other localizations of pain are also possible – somewhere on the side to the right or left of the foot, the arch of the foot, even behind the heel.

The pain can be intense – it is felt like a nail in the heel or glass, and the strength of the pain does not depend on the size of the spur.

As the disease progresses, in the areas of fibrosis, calcifications – calcium salts in the form of crystals begin to be deposited, so they lead to irritation of the surrounding tissues, “scratch” the mucous membranes of the joints, which leads to inflammation, severe pain, accompanied by edema of the surrounding tissues. These salts are insoluble and cannot be removed with “lotions” and “grandmother’s recipes”.

The patient’s gait changes, because when experiencing pain, the patient automatically tries to relieve the injured leg, steps sideways, on a toe, limps. If both legs are affected, then walking becomes problematic in principle.

X-ray and ultrasound reveals the presence of a thorn or growth on the calcaneus, facing inward


These are such measures as the fight against excess weight, wearing orthopedic shoes, it is necessary to carry out gymnastics of the feet, reduce excessive sports loads or carry them out only in special shoes, and avoid injury to the feet.The most important thing is to seek help from specialists in time, preventing the development of the disease. Prompt treatment will reduce the risk of complications and promote complete healing.

Heel spur treatment in St. Petersburg: reviews and contacts of clinics

Orthopedists of St.

Petersburg – latest reviews

The doctor is excellent, he looked at me, did an ultrasound, everything went great.Overall helped me in solving my question. The doctor was attentive, explained everything. I can recommend it to my friends and acquaintances.


02 August 2021

The reception was exactly 1.5 minutes.The doctor prescribed only elastic underwear, although I have problems with veins. I did not find out anything by contacting this specialist. He didn’t even give me a conclusion. Only after the administrator called the doctor, I received an extract. I threw the money away.


July 19, 2021

At the appointment, the doctor listened to all my wishes (what I would like her to do), conducted an examination, made a diagnosis and prescribed treatment.The doctor is friendly, competent, ethical, knowledgeable, attentive. I got everything I wanted. I am very pleased with the quality of the reception.


July 15, 2021

An attentive and professional doctor. I received a complete consultation on the disease and treatment. The doctor explained everything to me in an accessible way.


06 May 2021

Valery Nikolaevich is a competent, attentive and educated doctor.He examined me and told me everything in an accessible way. I am very pleased and glad that I got to him!


10 September 2020

Vitaly Nikolaevich is a kind and polite doctor. He listened to me, drew up a summary and made recommendations.


July 26, 2020

Very friendly doctor.He explained all stages of treatment in detail, in an accessible way, described everything and made recommendations. The doctor made a positive impression! I was satisfied!


May 10, 2020

A good, attentive specialist. At the reception, a full examination was carried out. I answered all the questions, gave good recommendations. Map entries made. The child liked the welcome. Nice approach to children. We have no questions left.


18 march 2020

I liked everything, no comments.The doctor is a professional, I did everything right, everything is good, competently. All that is needed, said, told, advised. Everything was without any problems.


17 november 2017

Everything is fine, I liked the doctor, we decided everything that interested us. Evgeny Sergeevich explained to us, showed and even found pictures on the Internet. He gave us enough time. I can recommend it to my friends.


07 August 2021

Show 10 reviews of 1126 90,000

Causes of heel spurs

The main reason for the appearance of a spur is the presence of flat feet.As a result, the ligaments experience a strong over-tension, and some fibers of the ligaments can break and move away from the bone tissue. Because of this, an inflammatory process in the ligaments can begin, which goes to the bone tissue of the foot.

Another cause of spurs can be a heel injury, which often occurs in athletes.

Violation of metabolic processes inside the body; diseases associated with the spine; circulatory disorders in the lower extremities, especially in the elderly; excess weight; inflammation of the joints, all this also provokes the appearance of a spur.

This disease is also called plantar fasciitis, as a result of which the structure of the foot is disrupted at the base of the toes and heel. When in the morning a person, getting out of bed, takes the first step, the fascia ruptures again, which causes severe pain. With subsequent steps, the fascia is stretched, as a result, the intensity of pain sensations decreases. But prolonged walking or stress on the heel zone again provokes pain.

Constant tears and cracking cause tissue degeneration, its growth and the formation of seals.Due to persistent trauma, calcium builds up in the tissue, resulting in scarring. Over time, they ossify and transform into a dense growth called a spur.

A spur on the heel can appear in almost all people. However, there are factors that provoke this pathology:

  • Athletes fall into the risk zone – with injuries to the lower limbs or excessive stress on them. To prevent the disease, you will need to wear specially designed orthopedic shoes that are able to support the arches of the foot, partially relieving the heel zone.
  • This disease is often diagnosed in older people. Prerequisites for the onset of pathology in this case may be the presence of gout or osteoporosis.
  • People with diabetes mellitus, flat feet, gastrointestinal problems, fungal diseases should be on the alert.

Standing work, constantly carrying weights, walking in high heels can also be one of the reasons for the appearance of spurs on the heel. If you do not respond to the development of the disease in time, it will worsen.The very first symptoms should be the impetus for taking action and going to the clinic.

Symptoms of a spur

The manifestations of this pathology are quite bright and, as a rule, do not go unnoticed. Changes occur in the soft tissues, the mucous bags and periosteum become inflamed, the growth on the bone presses on these tissues. A severe pain syndrome appears in the heel area, especially when walking and completely stepping on it. It seems to a person that a nail or a sharp needle has been driven into it. The intensity of the pain does not depend on the size and shape of the growth, it happens that large ones are not felt, but small and flat ones give acute pain.

The disease, if left untreated for a long time, can lead to lameness, since a person is not able to step on the surface of the entire foot due to pain. In some cases, the heel may change color. The inflammatory process causes redness and roughness of the skin. Overweight people find it harder to tolerate this disease, their symptoms are more pronounced, since the pressure on the sore heel is greater.

Heel spur: treatment

Before starting to treat a heel spur, it is necessary to identify the cause of its appearance.Different methods are used in the treatment, they all go together, the main task is to relieve inflammation. So, the complex includes:

  • gymnastics with a therapeutic effect and massage to normalize blood circulation;
  • physiotherapy – UFO, electrophoresis, laser, application of magnetic fields, ultrasound and shock wave therapy;
  • Compulsory wearing of special orthopedic insoles.

Today, heel spur therapy includes a new modern method – shock wave procedure using the Duolith SD1 device (DUOLITH SD1).The main principle of its action is to transfer energy strictly to the affected area without disturbing the skin. Thanks to this method, inflammation and pain are relieved, the result is effective for a long time.

That is why the specialists of the medical center “EUROMEDPRESTIGE” have adopted this newest method of treatment using the Duolit SD1 apparatus. You can always seek detailed advice on the treatment of a heel spur at the department of the clinic on Shabolovskaya in order to get rid of this problem for a long time, or maybe forever.

VIVA Clinic

Heel spur or plantar (plantar) fasciitis is a chronic type of microdamage to the ligament of the sole. Due to this disease, a growth is formed on the foot, a kind of thorn, which causes soreness and other unpleasant symptoms.

Causes of the heel spur

In 9 out of 10 cases, the provoking factor for the development of the disease is the presence of flat feet, which increases the load on the foot in the heel area. Other causes of the disease include:

  • increased training intensity
  • Complications of received foot injuries
  • overweight
  • systemic diseases and pathologies, including gout, rheumatism, nerve damage
  • age-related changes
  • Abuse of wearing uncomfortable shoes (high heels)


The main manifestation of a heel spur is pain syndrome.It can be described as the feeling of a nail in the heel. Soreness first increases with support on this part of the sole, and subsequently without additional stress.

Other symptoms of the disease include the following:

  • Pain sensations that appear in the morning during the first steps or after a long break in walking
  • gait changes (the patient tries to shift the center of gravity to relieve pain)

Diagnosis and treatment of heel spur

The specialists of the Viva clinics in Kiev examine and interview the patient for the diagnosis of plantar fasciitis. Additionally, an ultrasound and / or X-ray is prescribed to exclude other diseases, for example, rheumatoid arthritis.

The need to treat the heel spur determines the likelihood of difficult complications, ranging from a partial loss of mobility (when a build-up reaches 2 cm or more) and ending with necrosis, suppuration, etc.

Complex therapy is offered in our clinic, which involves various methods of influencing both the problem itself and its root causes.As a medical treatment for the heel spur, anti-inflammatory drugs, local corticosteroids, and drug blockades for pain relief are prescribed.

Other effective therapies include:

  • Physiotherapy
  • therapeutic massage
  • ultrasound therapy
  • Laser treatment of a heel spur
  • shock-wave action
  • surgical intervention, etc.

Orthopedists-traumatologists of Kiev

Subdivisions where the procedure is carried out

Still have questions?