How to treat bone spurs in heel: Plantar Fasciitis: Symptoms, Causes, Diagnosis, Treatment
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!
Can you get rid of heel spurs? Treatment options and exercises
It is not possible to get rid of heel spurs without surgery. However, some figures suggest that heel spurs only cause pain in 5% of cases. If someone is experiencing heel pain, there may be another cause.
According to the American Academy of Orthopaedic Surgeons (AAOS), the most common cause of heel pain is plantar fasciitis, which occurs when the tissue that supports the arch of the foot becomes inflamed.
In this article, we look at what heel spurs are, how they relate to heel pain, and the treatments for heel pain.
Heel spurs are bony growths that extend from the heel bone to the arch of the foot. According to the AAOS, only 1 in 20 people with heel spurs will experience pain.
However, heel spurs do cause pain in some people. The symptoms of a heel spur can include:
- a bony protrusion
- tenderness on the bottom of the foot
Plantar fasciitis and heel spurs often co-occur. In 2012, researchers found that 89% of people with plantar fasciitis had heel spurs. Additionally, the authors of a 2015 review suggest that heel spurs may develop as a reaction to plantar fasciitis in some cases.
The symptoms of plantar fasciitis include:
- pain on the bottom of the foot, near the heel
- pain after a long period of rest or after sleep
- pain that gets worse when flexing the foot
- greater pain after, but not during, exercise
The only way to get rid of heel spurs entirely is by having surgery to remove the growths. However, doctors typically reserve surgery for cases that do not respond to any other treatments. According to the AAOS, surgery is a last resort because it can lead to chronic pain.
However, there are things that people can do to reduce heel pain and inflammation, such as:
- Rest: Activities in which a person’s feet hit a hard surface can make heel pain worse. A person with plantar fasciitis may temporarily need to reduce or stop activities such as running or aerobics.
- Cold therapy: Applying ice packs or rolling the foot over a cold water bottle for 20 minutes can help with foot pain by numbing the area and reducing swelling. A person can do this three to four times daily.
- Nonsteroidal anti-inflammatory drugs (NSAIDs): Over-the-counter (OTC) medications, such as aspirin or ibuprofen, can help with acute pain, but these drugs are not suitable for long-term pain relief. NSAIDs are not safe for everyone, so it is best to check with a doctor before taking them.
- Exercises: A doctor may be able to recommend some exercises and stretches to relax tight muscles in the feet and calves. If these are ineffective, they may make a referral to a physical therapist, who can devise a specific exercise routine for relieving heel pain.
- Supportive shoes: A person with heel pain may benefit from cushioned shoes, silicone heel pads, or custom-made orthotics. A podiatrist can provide supportive shoe inserts.
- Corticosteroid injections: A doctor may recommend steroid injections to help reduce inflammation and pain. However, too many injections can cause further problems, such as chronic pain.
More than 90% of people with plantar fasciitis improve within 10 months using nonsurgical therapies. If plantar fasciitis is the cause of a person’s heel pain, they may find that these nonsurgical approaches help.
A doctor can diagnose the cause of heel pain by performing a physical examination and X-ray to rule out other conditions, such as arthritis or fractures.
According to a 2015 review, physical therapy can help people with heel spurs improve their range of motion and keep their joints mobile. The AAOS recommend trying the following exercises for 4–6 weeks, under the supervision of a doctor.
To perform this stretch:
- Sit on the floor with the legs straight out in front.
- Wrap a towel around the ball of one foot and pull gently inward until there is a stretch.
- Hold the stretch for about 30 seconds and repeat 3 times.
- Repeat on the other foot.
Heel cord stretch
For this stretch:
- With the hands on a wall, place one leg forward with a slight bend in the knee.
- Place the other leg slightly behind the body and keep it straight.
- The heels should remain flat on the ground.
- Press the hips forward to feel a stretch in the calf and heel of the back leg.
- Hold the stretch for about 30 seconds.
- Switch the legs and repeat.
For this stretch:
- Sit on the floor with the feet flat on the ground and place a small towel in front of the feet.
- Grab the towel using the toes on one foot and bring it closer to the body.
- Relax the foot and then repeat 4 more times.
- Switch to using the other foot.
Golf ball roll
For this exercise:
- Sit in a chair and roll a golf ball under the painful foot.
- Continue for several minutes, without extending the leg too far from the chair.
- If the pain is in both feet, repeat with the other foot.
To perform this exercise:
- Sit in a chair with the feet not touching the floor.
- Write out the letters of the alphabet with the feet, using only small movements in the foot and ankle.
- Perform this exercise in one foot and then the other.
According to the American Podiatric Medical Association, heel spurs occur due to muscle and ligament strain in the foot. Repeatedly tearing or damaging the membrane that covers the heel bone leads to hard calcium deposits building up over time.
Heel spurs can happen as a result of the repetitive stress that some high impact exercises, such as running, place on the feet. Other causes and risk factors include:
- Biomechanical imbalance: Tight muscles in the calf or foot, high arches, and gait abnormalities can lead to heel spurs. Shoes that do not support or fit the foot well may also contribute to their development.
- Obesity: A review article notes that two meta-analyses found that a higher body mass index (BMI) and heel spurs are associated with chronic heel pain.
- Age: According to a 2014 study, large heel spurs are more common in people over the age of 40 years.
- Other conditions: Heel spurs are associated with arthritis and ankylosing spondylitis, as well as plantar fasciitis.
People can reduce the risk of heel pain by:
- wearing supportive shoes that fit well
- wearing shock-absorbing shoes when exercising
- warming up and stretching the legs and feet before exercise
- maintaining a moderate weight
Surgery is the only way to get rid of heel spurs entirely. However, as people with heel pain often have other conditions that cause pain, such as plantar fasciitis, they may find relief by following the general recommendations for reducing heel pain.
Rest, ice, NSAIDs, and physical therapy can help people with heel pain, and cushioned pads and shoes can reduce the impact of walking on the feet. In more severe cases, doctors may prescribe steroid injections or surgery.
People with heel pain should discuss their symptoms with their doctor, who can diagnose the cause of the pain and recommend the best approach.
Symptoms, risk factors, and treatment
A heel spur is a condition where a calcium deposit grows between the heel and arch of the foot. What are the symptoms of heels spurs and what increases a person’s risk of developing them?
Heels spurs may happen independently or may be related to an underlying health condition. People often assume that heels spurs are the cause of any pain in the heel, but other factors can also cause heel pain.
This article explores the symptoms of heel spurs, as well as other causes of heel pain. It also discusses the causes, risk factors, and treatments for the condition.
Share on PinterestSymptoms of heel spurs may include heat radiating from the affected area, a dull ache in the heel, and a sharp pain in the heel when standing.
A heel spur is a bony outgrowth that can occur on the underside of a person’s foot. They are also known as calcaneal spurs or osteophytes.
Heel spurs may be pointy, hooked, or shelf-like. The outgrowth of a heel spur extends from the underneath of the heel towards the arch (the middle of the foot). This area of the foot is called the plantar fascia.
When seen on an X-ray, a heel spur may be up to half an inch long. If an X-ray is unable to confirm a suspected heel spur, a doctor may refer to the condition as “heel spur syndrome.”
Symptoms of heel spurs can include:
- sharp pain like a knife in the heel when standing up in the morning
- a dull ache in the heel throughout the rest of the day
- inflammation and swelling at the front of the heel
- heat radiating from the affected area
- small, visible bone-like protrusion under the heel
- point of tenderness at the bottom of the heel that makes it hard to walk barefoot
If a person experiences these symptoms, a doctor may take an X-ray of their foot to determine the problem. Seeing the protrusion on an X-ray is the only way to be sure a person has heel spurs.
Not everyone with a heel spur will experience all of these symptoms. Some people with heel spurs may experience no symptoms at all. These people may only discover they have heel spurs if they have an X-ray for another reason.
Heel spurs happen when long-term muscle and ligament strain wears out the soft tissues in the heel. Tearing the membrane that covers the heel bone is also a cause.
The heel can also become more vulnerable with age. A 2015 review of heel pain noted that as a person ages, the pads in the heel wear down and fail to provide shock absorption.
Over time, calcium deposits can build up under the heel. These deposits form bony protrusions, which are heel spurs.
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Risk factors for heel spurs may include athletic activities such as running and jumping.
There is a range of things that increase the risk of developing heel spurs. These include:
- Athletic activities: Running and jumping can wear down the heel and arch of the foot.
- Activity on hard surfaces: Frequently walking, running, or jumping on hard surfaces can wear down the heel.
- Trauma to the heel: Bruising the heel and tearing the membrane that covers it can lead to heel spurs.
- Getting older: A 2008 study found heel spurs to be common in older men and women.
- Being female: A 2014 study found that heel spurs are more common in women than men.
- Being overweight: Researchers also found that heel spurs were related to obesity.
- Improper footwear: Frequently wearing shoes that do not fit properly, have lost their support, or are not supportive, such as flip-flops, can lead to heel spurs.
There are also some underlying medical conditions that may cause heel spurs. These include:
Heel spurs are often confused with a condition called plantar fasciitis. Having plantar fasciitis increases a person’s risk of developing heel spurs. Heel spurs often occur in people who already have plantar fasciitis.
Up to 15 percent of people with foot symptoms that require medical attention have plantar fasciitis.
There are important distinctions between heels spurs and plantar fasciitis. A heel spur is a calcium deposit that forms a bony protrusion along the plantar fascia.
In contrast, plantar fasciitis is a condition where the plantar fascia gets irritated and swollen, which causes pain in the heel.
Doctors often describe the plantar fascia as a bowstring-like tissue. It stretches underneath the sole and attaches to the heel. Plantar fasciitis results from an unusual amount of force on this part of the foot.
Possible causes of significant force include:
- being obese
- walking or otherwise exercising the foot for a very long time
- wearing shoes that do not support the arch of the foot
Having diabetes is also a risk factor for plantar fasciitis.
Plantar fasciitis usually goes away without treatment. Heel spurs, on the other hand, are permanent unless medically treated.
Share on PinterestResting the feet may help to reduce the swelling and pain of heel spurs.
Treatments for heel spurs may include:
- Rest: Getting plenty of rest and taking pressure off the feet can help to reduce pain and swelling in the affected area.
- Applying ice: This can help reduce pain and swelling.
- Using custom-made orthotics (shoe inserts): These donut-shaped inserts go inside the shoe to take the pressure off the heel.
- Wearing cushioned sports shoes: These may also help to relieve pressure and reduce pain.
- Anti-inflammatory medication: This helps to reduce swelling.
- Cortisone injections: These reduce swelling and pain in the affected area. They are a stronger option if over-the-counter anti-inflammatory medication is not effective.
- In rare cases, surgery may be necessary to remove the heel spur. However, the above treatments are usually effective, and surgery is not needed.
If heel spurs are caused by an inflammatory type of arthritis, treatments for the underlying condition may also improve symptoms.
The outlook for heel spurs is positive. The calcium deposit will always be there unless surgically removed, but this is not normally problematic, as treatments to reduce pain and swelling tend to be effective.
In cases where treating the symptoms is not effective, surgery to remove the heel spur is possible.
When Heel Pain Is Caused by Bone Spurs
Like some other tissues in the body, bones can regenerate themselves and develop new growth. Unfortunately, sometimes the new growth comes in the form of an irregular protrusion on the bone known as a spur.
See What Is a Bone Spur?
Plantar Fasciitis: Initial Treatment Options
Plantar fasciitis and heel spur syndrome can both be treated through physical therapy.
See Plantar Fasciitis: Initial Treatment Options
Bone spurs are frequently harmless and often go undetected. But if they impinge on nearby soft tissues like tendons or ligaments, they can cause pain and immobility.
Bone spurs can occur at many sites in the body, but there are two common sites in the heel where spurs can cause pain and interfere with your ability to do activities that involve running and jumping.
See The 2 Common Types of Heel Spurs
This guide explains the causes and symptoms of both types of heel spur:
Pain on the bottom of the heel
Pain on the bottom of the heel toward the front (just behind the arch) may be the result of heel spur syndrome. This occurs when a bone spur forms at the spot where the plantar fascia, a fibrous band that runs down the sole of the foot, inserts into the heel bone.
See Is Heel Pain Caused by Heel Spurs or Plantar Fasciitis?
But the heel pain may not be caused by the bone spur. In fact, it’s much more likely the pain is the result of injury or inflammation in the planta fascia itself: plantar fasciitis. Even if imaging results reveal the presence of a bone spur, it’s probably not responsible for the pain.
See Plantar Fasciitis Symptoms
But whether the pain was caused by bone spur syndrome or plantar fasciitis, both have similar initial treatment recommendations: resting, changing footwear, and stretching the calf and plantar fascia.
See Plantar Fasciitis: Initial Treatment Options
Pain on the back of the heel
Another spot that’s susceptible to the growth of bone spurs is at the top and back of the heel, where the heel bone connects with the Achilles tendon.
See Achilles Tendon Conditions Signs and Symptoms
A bone spur in this location can irritate the Achilles tendon, causing pain and inflammation—this is known as insertional Achilles tendonitis. It usually develops over time and is more likely to affect people in their 40s, 50s, or 60s.
See Common Running Injuries: Pain in the Ankle or Back of the Heel
Insertional Achilles tendonitis is different than regular Achilles tendonitis, which causes pain higher up, at the bottom of the calf.
See Diagnosing Achilles Pain
Bone spurs can be treated nonsurgically and surgically, but the first step is to treat the inflamed structure (like the plantar fascia or Achilles tendon) that triggered the spur in the first place.
Achilles Tendonitis and Tendon Injuries
Plantar Fasciitis Risk Factors
How Long Do Heel Spurs Last?
Although we treat all manner of pain, infections, and injuries in and around the feet and ankles, heel pain is no doubt the most frequent complaint we deal with.
So it’s not too rare for us to hear a question like, “How long will these heel spurs last, doctor? When are they going to go away?”
Well, here’s the honest answer:
Heel spurs last forever. Unless we remove them surgically, they will never go away.
We know—that sounds bad. But before you freak out, there are a few other important things you should know. And the most important one is this: just because you have a heel spur doesn’t mean that the heel spur is causing pain. Do not hesitate to contact us if you are experiencing pain from heel spurs.
Still confused? Let’s break it down.
A Normal Response to Trauma
So at this point, we should talk about why heel spurs happen in the first place. The short answer is that it’s a secondary biological response to soft tissue trauma that isn’t healing.
In the vast majority of cases, you don’t get heel spurs unless you have a bad case of plantar fasciitis first. In this condition—which is the actual most common cause of heel pain—the strong plantar fascia ligament on the bottom of the foot becomes overstressed, overstretched, and inflamed. This causes it to “pull away” from the point where it attaches to the bottom of the heel bone, leaving a “gap.”
Your body’s attempt to fix this problem is, essentially, to create new bone. Hard deposits of calcium get left on the surface of the heel bone, filling in the space where the fascia used to be. If your plantar fasciitis is untreated for a long period of time, the spur could reach half an inch in length or more!
A Permanent Addition—But Not Necessarily a Permanent Problem
So what happens to that heel spur once the plantar fasciitis finally goes away? Nothing, that’s what. That bony tissue isn’t simply going to break down or dissolve away. It’s there to stay.
But here’s the thing:
Once that plantar fasciitis is gone, the heel spur that remains usually doesn’t cause any problems. In, fact, most heel spurs are themselves totally painless. Unless the spur is pressing on a particularly sensitive nerve or tissue, you shouldn’t really feel it at all.
And because plantar fasciitis is so common—and heel spurs are so commonly linked with it—a lot more people have heel spurs than you might think. By some estimates, as many as 40 percent of the general population have them—and in most cases have had them for years.
We can attest to this fact: a lot of times, heel spurs will show up on X-rays when we’re running diagnostics for completely unrelated issues, like bunions or stress fractures. Often these people do not have any heel pain symptoms whatsoever.
But What About When They Do Cause Pain?
As we said, if you come to our office with heel pain along the underside of your foot, it’s most likely going to be plantar fasciitis, or possibly something like stress fractures or a pinched nerve. And we’ll put you on a treatment plan.
Most of the time, the conservative treatment methods we recommend are going to provide the relief that you need, even if the heel spur itself is contributing at least partially to your symptoms. Custom orthotics, for example, may be an excellent treatment option for both fasciitis and spurs.
That said, it is still possible that the spur may be causing some pain that conservative treatments can’t alleviate, even once the plantar fasciitis is gone. It’s rare, but it does happen.
If this is the case, surgery may be considered. There are a couple of options, including releasing part of the plantar fascia that may be rubbing painfully against the spur, or even removing the spur itself. We’ll carefully consider the best course of action for your situation and discuss all your options with you in detail.
But again, this is very rarely necessarily. Conservative treatments are effective well over 90 percent of the time.
Either way, though, you’re going to want to get a thorough evaluation as soon as you can, whenever you notice heel pain symptoms starting to impact your daily life. The earlier you deal with heel pain, the better. Not only does it mean you won’t be hurting for as long, but it also means that conservative treatments are more likely to work. You may be able to avoid the development of a spur in the first place, or at least limit its size.
To schedule an appointment with the Community Foot Clinic of McPherson, give us a call today at (620) 241-3313.
Heel Spurs | Orthopedic Medical Center
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.
Jerome R. Friedland, M.D.
Jerome R. Friedland, M.D., completed his undergraduate studies in his native state of New York, then traveled abroad to study medicine. After medical school, he moved to California and
David L. Feingold, M.D.
Dr. David Feingold is a board-certified orthopedic surgeon
specializing in arthroscopic sports medicine, biologic joint
preservation and joint reconstruction at his practi
Maurice A. Perry, D.P.M.
Maurice A. Perry, D.P.M., is board-certified in reconstructive
surgery of the foot and ankle. He was born in Washington, D.C., and
graduated from the University of Virginia with Bach
Jonathan Berkowitz, M.D.
Dr. Jonathan Berkowitz is a fellowship-trained orthopedic sports medicine surgeon. He specializes in sports-related injuries. He provides total care of the shoulder, hip and knee, from minimally invasi
Heel Pain & Spur Symptoms & Treatment
The human foot is one of the most commonly injured parts of the body. That’s why it’s no surprise that the heel bone (calcaneal tuberosity), which is the largest bone in the foot, is frequently injured as well. Injury to the heel bone can result in pain from nearly every angle: back, front, sides, and bottom.
Reasons for Heel Pain
Besides direct fractures and bruising, the biggest causes of heel pain are other injuries to the bone, ligaments, tendons, and tissue of the foot and ankle. These injuries are commonly caused by stress, strain, and too much pressure on the various parts of the ankle and foot. Here are some of the typical activities that have led to heel pain for our patients here in Middle Tennessee:
- walking, running, or jumping on hard surfaces
- wearing poorly constructed footwear
- being overweight
Injuries that Cause Heel Pain
Here are some of the specific injuries and ailments that impact the heel:
- Plantar fasciitis (possibly the highest cause of heel pain) – irritation and inflammation of tissue
- Tarsal tunnel syndrome – caused by compressed nerves
- Rheumatoid arthritis & Gout – usually impacts the big toe joint, but can cause heel discomfort as well
- Bursitis – a small growth of soft-tissue or fluid that can mimic a heel spur
- Haglund’s deformity – an enlargement of bone on the back of the heel
- Achilles tendinitis – an injury to the Achilles tendon which connects the calf muscle to the heel bone
- Bone bruises – inflammation of the tissues that cover the heel bone
- Fracture (break) – typically a stress fracture
- Excessive Pronation – similar to an overuse injury, this is caused by over working the normal movements and workings of the foots arch
- Heel spurs – buildup of calcium deposits typically found at the bottom of the heel
Heel Spurs & Causes
Heel spurs are one of the most common heel deformities. These calcaneal spurs sometimes cause pain, but are often painless. They can develop on their own, but are sometimes brought on by other foot and heel injuries.
A heel spur is a buildup of calcium deposits on the heel that create a spur like shape up to half an inch in length. These pointed bony spurs are typically located at the bottom of the heel (inferior calcaneal spur), and the back of the heel (posterior calcaneal spur).
Many of the most common causes of heel spurs are similar to other heel pain causes. Here are some of the issues that can lead to a heel spur:
- Plantar fasciitis
- Poorly fitting shoes or consistently wearing flip-flops
- Walking gait
- Stretching of the tissue connecting the heel & ball of the foot
- Repeatedly tearing away of the membrane that covers the heel bone
- Calcium build ups due to ongoing injuries and stress
Symptoms of Heel Injuries & Spurs
The most obvious symptom of a heel injury is simply pain on your heel. However, with the complex makeup of the foot and ankle, a heel injury can cause pain to radiate across the foot – making it harder to initially diagnose.
Here are the symptoms that can help you better understand if you’re facing a heel injury:
- Swelling on the bottom or back of the heel
- Redness on the heel
- Radiating heat from the heel
- Pain on the arch of the foot
- An initial shooting pain when you first stand up
Often the best way to diagnose a heel injury and formulate a treatment option is through an X-ray.
Diagnosing Heel Spurs
Heel spurs do not always cause pain, and bone protrusions are not always visible to the naked eye. At times, heel spurs have no symptoms at all.
Sometimes the only way to tell if you have a heel spur is through an X-ray or another foot or ankle injury diagnosis. However, here are some heel spur symptoms you may be able to recognize without the help of an X-ray:
- Chronic heel pain – especially when active
- Pointed and sharp pain on the heel
- Points of tenderness at the bottom or back of the heel
- Difficulty & irritation when walking barefoot
- A visible bump on the heel
- Irritability on the heel from various shoe types
Treatments: How To Cure Heel Spurs & Pain
Heel injuries and pain, whether caused by heel spurs or not, often have similar treatments.
Heel Pain & Spur Treatment
When our podiatrists formulate a treatment for heel pain or spurs they look to reduce inflammation and irritation, while also preventing future injury. Here are some of the non-surgical treatment options:
- Icing & cold compress
- Night splints
- Cortisone shots
- Protective boots
- Anti-inflammatory & pain medications
- Custom orthotics & inserts
- Physical therapy
Shoes For Heel Spurs
Not only do custom orthotics and inserts help with heel spurs, but so do the shoes you choose to wear. Specifically, the best shoes to prevent or aid heel spurs are shoes with:
- Heavily cushioned soles, such as running shoes
- Shock absorbent
- Supportive heel counter
- Are not too tight or loose
Conservative and Surgical Treatments
Our podiatrists at Advanced Foot & Ankle will always look to conservative treatment options for your heel pain and injuries first. However, at times surgery to remove spurs or release the plantar fascia may be necessary.
If you’re experiencing heel pain, injuries, or spurs schedule an appointment at one of our Middle Tennessee podiatry clinics today for an assessment!
– This is an overgrowth in the area of the plantar surface of the calcaneus tubercle. it
the disease is widespread – its share among the total mass of pathological
conditions of the musculoskeletal system is 10%. The development of this disease
possible at any age, in any person with predisposing
factors, although spurs are most often diagnosed in women over 40 years old.
while walking, the entire weight of a person falls on the plantar fascia, which
supports the transverse and longitudinal arch of the foot.Normally, it allows
cushion the gait and distribute the load correctly. But with excessive (a
especially repetitive) stress at the attachment points to the heel bone
local aseptic inflammation begins to develop, and then
degenerative-dystrophic processes – replacement of healthy elastic
connective tissue pathological coarse fibrous and the appearance of bone
growths (enthesophytes, or actually “spurs”).
Reasons for the development of the disease:
Excessive physical activity during sports.
Foot injuries: bone fractures, soft tissue bruises, ligament injury
Diseases accompanied by circulatory disorders, changes
metabolic processes, for example, diabetes mellitus, gout.
Wearing uncomfortable shoes, lack of shock-absorbing insoles in them, thin and
rigid sole. Wearing high-heeled shoes.
Longitudinal flat feet – distribution of the load on the foot occurs
unevenly, the fascia suffers from excessive tension.Heel spur
formed in 90% of people with this pathology.
Connective tissue diseases (ankylosing spondylitis, rheumatoid arthritis)
able to provoke the development of a heel spur.
of a sharp, burning character, of varying intensity, arising (or
increasing) while walking, running, jumping or even with the slightest support on
heel. The intensity of pain does not depend on the size of the “thorn”.So, patients with
small flat spurs may have more severe pain than humans
with large growths. Characterized by increased pain after a night’s rest – for
during sleep, micro-tears of the fascia fused with shortening, with movements again
a micro-rupture occurs, and this is due to the intensification of the pain syndrome. On the
throughout the day, the fascia stretches, the painful sensations decrease slightly,
but in the evening they intensify again due to loads and the formation of new
day after day, trauma to the plantar fascia leads to cicatricial changes,
as well as deposits of calcium salts at the site of attachment to the bone, which leads to
the formation of bone growths.
to unload the hindfoot, the person’s gait changes. External
there are no pathological changes in the heel area. Rarely to be found
mild edema of the heel area and calcification.
clinical examination of the patient (pressure pain, limitation
foot mobility, pain when walking)
X-ray of the foot – allows you to “see” a painful formation (osteophyte
or enthesophyte) – a wedge-shaped hook extended towards the fingers, evaluate it
the size and condition of the surrounding soft tissues.It is also recommended to do
X-ray while standing, under load – this allows you to assess the degree of flat feet
and identify possible deformities of the bones of the foot)
Computed tomography, magnetic resonance imaging, although they have more
high resolution rendering, but are not of any decisive importance in
diagnosis, and hence the treatment of this disease.
Ultrasound examination with a heel spur has the lowest diagnostic
value, since it visualizes the bone component of a given
Since the main causative factor is
overstrain of the plantar fascia, then the load on the feet should be limited
(suspend sports, normalize increased body weight, reduce
walking and standing time). Unloading the diseased limb and eliminating excessive
heel pressure should precede any treatment.
Wearing insoles with instep supports also
help to evenly distribute the load on the arches of the foot and, accordingly
create favorable conditions for recovery.
stop and walk barefoot on the warm sand also contributes to the complex
treating this disease.
Drug treatment includes
the use of non-steroidal anti-inflammatory drugs, as well as local
injections with glucocorticoids (hormonal drugs). Application of the latter
although it reduces pain, but with frequent (more than 3 injections) use
causes degenerative changes that aggravate the course of the disease.Also, injections with glucocorticoids are dangerous if the rules of asepsis are violated.
the development of severe infectious diseases – purulent abscesses, phlegmon and even
Physiotherapy treatment has
most important in the treatment of torture spurs. It is possible to use almost everything
types of physical impact on the pathological process.
laser therapy – improves blood circulation, accelerates metabolic
processes, enhances the repair (restoration) of damaged structures;
2.shock wave therapy – allows you to “crush” bone growths, accelerates
ultrasound treatment, phonophoresis with anti-inflammatory drugs –
application of ultrasonic waves to carry the drug to the site
in the complex of treatment, although with less efficiency, it is possible to use
other methods of physiotherapy – electrotherapy (amplipulse, darsonval),
magnetotherapy, vacuum therapy, etc.d.
There are also such treatment methods
as taping and the use of night orthoses.
Taping – Overlay technique
on the plantar surface of the foot with a special tape-plaster, allowing
fix the plantar fascia in an elongated state.
Night orthoses are
special orthopedic aids that fix the leg at a right angle for
relaxing the plantar fascia and creating favorable conditions for fusion
micro-fractures of the latter.
If conservative methods do not help
get rid of the problem, it is necessary to resort to surgical treatment. IN
During the operation, an incision of the skin and subcutaneous tissue is made in the spur area.
Further along the fibers, the plantar fascia is intersected and removal is performed
osteophyte. It should be noted that surgical intervention is extremely rare.
90,000 Heel spur treatment. What methods and means are effective?
At least one in ten people experience heel pain from time to time.The causes of discomfort are different. However, severe, sharp pain in the heel is most often a symptom of plantar fasciitis, or, as this disease is popularly called, heel spurs.
Calcaneal spur in 90% of cases develops against the background of flat feet. With this ailment, the correct distribution of the load on the foot changes, the tendons are deformed, and the places where the tendon is attached to the bone begin to become inflamed. Against the background of plantar fasciitis, the formation of marginal bone growths is possible – they are called “heel spurs”.
Heel spur: causes and symptoms
Heel spur, like any other disease, develops gradually and does not manifest itself immediately. Sometimes the first signs of plantar fasciitis are accidentally found on an X-ray taken for a completely different reason. The first symptom of a heel spur is a sharp pain in the heel when the legs are loaded. The patient has the feeling that he has stepped on a nail or a shard of glass. In the early stages, the pain subsides by midday and reappears in the evening.As the heel spur develops, the pain becomes constant and so severe that the person practically loses the ability to walk without the help of crutches.
A very common cause of a heel spur is flat feet. However, being overweight can also cause plantar fasciitis, which also puts too much stress on the foot. A heel spur also occurs in those who suffer from diseases of the joints of the lower extremities or the spine, infectious lesions of the periosteum, and circulatory problems.Often it develops in lovers of high-heeled shoes – such shoes are not intended for daily wear, and women of fashion, in addition to male attention, also risk deforming the foot. According to statistics, a heel spur usually appears in people over 40 years old, and women from large cities suffer from this ailment more often than men and villagers who are accustomed to ugly but comfortable shoes.
Methods for treating a heel spur
Since a heel spur rarely appears “on its own”, therapy should be comprehensive and aimed at the underlying disease.It is better not to postpone the treatment of plantar fasciitis: this disease will not go away on its own, and the condition will only get worse over time.
These days, the treatment of heel spurs is not the most difficult task for doctors. There are also folk remedies against it, but their effectiveness is questionable. While the patient spends time on self-made rubbing, the disease develops and progresses. Therefore, at the first sign, you need to consult a doctor who will conduct an accurate diagnosis and prescribe a comprehensive treatment.In most cases, this disease does not require surgery. The pain is caused not by the bone outgrowth itself, but by the inflammation of the bone tissue. Sometimes patients with a large spur almost do not experience unpleasant sensations, while a spur, barely visible on an x-ray, delivers considerable torment. The main means of treating plantar fasciitis are physiotherapy, unloading of the feet with a variety of orthopedic devices, physiotherapy exercises and massage. Physiotherapy methods are especially effective.
- Laser therapy improves blood circulation in the area of inflammation and relieves pain. Although laser treatment of a heel spur may not completely cure the disease, it does provide noticeable relief.
- UHF Therapy is based on the use of high frequency alternating current with low voltage and power. UHF therapy promotes the expansion of capillaries in soft tissues, increases blood circulation and reduces inflammation.
- Magnetotherapy gives the same effect as UHF therapy, but it is achieved by exposing the affected area to an alternating magnetic field.
- Electrophoresis is a long-proven painless method of delivering medicinal substances directly to the affected tissues. Two metal plates are attached to the sore spot, one of which is wrapped in a cloth soaked in medicine. Then a weak current is applied to the plates. The charged particles carry drug substances into the tissue.
- Shockwave Therapy is the ultimate heel spur treatment. This is a new and rather productive method.It is based on the therapeutic effect of a low-frequency sound wave. UHT quickly relieves pain and swelling, improves blood circulation, repairs damaged tendons and breaks down calcifications.
How to cure a heel spur? – Evolife Medical Center
A heel spur is a pathological formation of bone tissue in the form of an styloid or hook-shaped outgrowth ranging in size from 0.5 to 1 cm, and in some cases up to 15 mm, on the surface of the calcaneus at the place of attachment of the plantar ligament and the Achilles tendon.It can have several locations – both on the upper edge of the calcaneal tuberosity and at the tendon of the triceps muscle. It is often accompanied by inflammation of the plantar fascia and is a common cause of pain in the heel area.
- Morning pains that subside during the day and intensify in the evening.
- With the progression of the process – constant pain.
- Acute thorn / nail / needle pain and / or burning sensation.
- Transition of localization of pain from the foot to the heel area.
- Increased pain after exercise.
- Change in gait.
- Compaction during palpation of the heel area.
- Restriction of foot mobility.
It is important to remember that patients with a heel spur do not always have manifestations of pain symptoms, and the cause of pain may not be the spur itself, but systematic microtrauma of the calcaneus and foot.
Diagnosis of a heel spur
It is important to make a differential diagnosis of diseases with similar symptom complexes (see.Berchterew’s disease, rheumatoid arthritis, Reiter’s symptom, fractures and injuries). On examination, there should be no pathological changes such as redness of the foot area, cracks and calluses. On palpation, the pain is localized at the site of attachment to the plantar fascia, with a characteristic increase in pain with the extension of the big toe. Sometimes one examination and palpation is not enough, you have to confirm the diagnosis with additional research methods:
- CT (computed tomography) or MRI (magnetic resonance imaging)
- Ultrasound (ultrasound)
How to cure a heel spur?
Make an appointment with a specialized doctor for an accurate diagnosis and effective treatment.
This type of massage enhances lymph and blood flow, relieves pain, promotes resorption of hematomas, improves nutrition of damaged tissues, accelerates the formation of callus, prevents muscle atrophy and stiffness in the joints.
An acoustic shock wave improves blood circulation in the affected tissues, activates their healing processes, destroys microcrystals and fossilized fibroblasts in the joints.
Ultrasonic waves have a mechanical and thermal effect on tissues, activating metabolic processes in cells and increasing the immune capacity of the body.
Heel spur treatment
So what is a heel spur?
Nothing more than inflammation of the fascia (hence the name plantar fasciitis) that connects the heel and metatarsal bones. Thanks to this design, our foot retains its correct shape and smoothly absorbs while walking, softening the gait.
Causes contributing to the appearance of a “heel spur”:
- flat feet , this pathology leads to a redistribution of the load on the arch of the foot, resulting in inflamed plantar fascia at the site of attachment to the heel.
In the Center for the Treatment of Pain at the Ram-Clinic, flat feet are detected in the early stages, corrective treatment is carried out, which further contributes to the correct placement of the foot and the prevention of such diseases as “heel spur” and other pathologies of the musculoskeletal system.
- overweight , this pathology leads to a significant load on the foot;
- Excessively intense physical activity , which are received by athletes-runners for long distances, amateur tourists, practicing hiking long distances without rest and in the wrong shoes;
- various inflammatory, vascular, degenerative diseases of the lower extremities : deforming arthrosis, diabetic polyneuropathy, rheumatoid arthritis, etc.
All these negative phenomena lead to microscopic tears in the place where the plantar fascia attaches to the calcaneus. Repeated microtrauma of the fascia (especially the point of its attachment to the calcaneus) leads to a chronic inflammatory process as a result of which a pathological bony outgrowth of the calcaneus appears – a heel spur, which causes pain.
Symptoms of the “heel spur”: burning, excruciating pain in the heel, many patients describe it “as if stepping on a nail.”After rest, especially after a night’s sleep, relief comes, but the pain returns again with another load on the lower limbs. And the intensity of pain does not depend on the stage of the disease.
If the “heel spur” is not treated, painful sensations begin to appear even with the smallest load on the foot. A person begins to adapt when walking, involuntarily unloading the heel area, thereby overloading the forefoot. In more advanced cases, you can see how patients with such a pathology literally walk on their toes.As a result of uneven load on the foot, the disease can be complicated by transverse flat feet and other problems with the ankle, knee and even hip joints.
Many patients are in no hurry to seek qualified medical help, trying to solve the problem with folk remedies, which aggravates their condition, continuing to injure the plantar fascia.
At the Pain Treatment Center of the PAM Clinics, heel spur treatment is carried out with the most modern method of shock wave therapy (SWT) using equipment with Dornier Aries electromagnetic emitters and a unique system of intelligent wave focusing (Smart Focus) for orthopedics and traumatology.
Let’s see what is the advantage of this method in relation to drug blockade and surgical treatment:
- drug blockade : injection of corticosteroid drugs into the affected area. This method brings relief for a short period of time. Continuous administration of such drugs is contraindicated, because leads to leaching of calcium from bone tissue and, in the future, to osteoporosis and even to aseptic necrosis of bone tissue.And the cause is still not eliminated;
- Surgical treatment in the surgical department of the hospital : Operation is the most radical method of treating a heel spur. But as you know, any operation is a long process of recovery and rehabilitation, and success in such treatment is not always achieved, moreover, relapses often occur.
- Shockwave therapy (SWT) treatment : by far the most effective method, according to statistics, it accounts for more than 90% of ill-treatment compared to other methods and has no side effects and contraindications.
How does a shock wave work?
Shock wave – an acoustic wave that delivers energy to the painful area and skeletal muscle tissues in the subacute, subchronic and chronic stages of the disease. Shock waves are characterized by a specific pulse shape and pressure, which usually ranges from 1 to 5 bar, which allows for gentle therapy, while providing a stimulating effect and launching healing, reparative and restorative processes in biological tissues.
If we consider the treatment of the heel spur specifically, then with the help of a shock wave, the destruction of calcified fibroblasts occurs.
Calcification most often leads to micro tears and other tendon injuries. Shock waves “break” the formed calcifications, which are further removed through the lymphatic system of the body, and, thus, the condition of the tendons improves.
It is also important to note that UHT has not only a point effect on the affected areas, but also has auxiliary healing properties on the body.So, in the zone of influence of waves, metabolic processes are improved, there is a significant stimulation of blood flow, especially in the capillaries, which contributes to a faster resorption of calcium salts, areas of fibrosis and stimulates tissue regeneration, which contributes to the speedy recovery of the patient.
How the procedure itself is carried out:
- a special gel is applied to the area of exposure to the shock wave, a small-sized applicator is installed directly above the affected area at the desired angle, which transmits impulses of sound waves to a depth of 7 cm.
Treatment of a heel spur with UHT usually consists of 5-7 sessions, 15-20 minutes each, which are best done on a schedule with intervals of 2 to 4 days. In 1 out of 10 patients, a temporary increase in pain is possible approximately 6-8 hours after the procedure, however, after 2-3 days, the intensity of pain decreases and further treatment can be carried out.
Advantages of UHT:
- after 1 session there is a significant reduction in pain;
- Good patient tolerance;
- practically has no side effects and contraindications;
- outpatient treatment without surgical interventions, without the use of non-steroidal anti-inflammatory drugs and corticosteroids, while maintaining social activity;
- High rate of recovery compared to other treatments for plantar fasciitis.
Treatment of plantar fasciitis – the source of heel pain. Clinic “URO-PRO” in Yekaterinburg
Symptoms and diagnostics
The main symptom of plantar fasciitis is severe heel pain. Somewhat less often, it can spread along the fascia, it occurs when the foot is loaded. People compare it to the sensation of stepping on a nail, hot rod, or broken glass. At first, the pain subsides by the middle of the day and resumes in the evening, but as the process progresses, it becomes constant and so severe that patients become unable to work.Some of them cannot walk without crutches. To confirm the diagnosis, the following examination is carried out:
- X-ray of the foot. They look at the area of the heel, where they find inflammatory changes in soft tissues or the growth of osteophytes.
- Ultrasound of the heel region. They look at the soft tissues of the foot, as well as the plantar fascia itself.
Treatment is aimed at eliminating pain and inflammation. First of all, the patient is advised to unload the foot or heel.For this, the wearing of special orthopedic insoles is prescribed, which minimize trauma to the affected tissues. In addition, physiotherapy and medication are prescribed.
One of the most effective methods of heel pain is shock wave therapy (SWT). It is based on the treatment of the affected focus with acoustic waves with specified parameters. They have a vibrational effect on pathological tissues, which gives a good therapeutic effect. The technique helps to relieve inflammation of the plantar fascia and remove the sharp edges of the heel spur.
UHT in the treatment of heel spurs
UHT can be an independent method of treating pain in heel spurs, or it can be used as part of complex therapy, for example, in conjunction with magnetic laser therapy (MLT). For the procedure, special equipment is required that will generate acoustic waves of a given frequency (the human ear does not perceive them). They are focused using a special attachment, which is installed in the projection of the painful area.
The method is based on the fact that pathologically altered tissues cannot withstand the action of a shock wave, since their membranes are not elastic enough. Because of this, cells are destroyed and die. The same effect is exerted on pathological formations – osteophytes, cicatricial deformities, etc. Under the action of a shock wave, they loosen and soften. The procedure is carried out as follows:
- Using palpation, the place of greatest pain in the heel is determined.A special gel is applied there, which improves the conductivity of sound waves, and the applicator of the UHT apparatus is installed.
- One treatment takes about 10-15 minutes. During the session, the patient may experience pain of varying degrees of intensity.
- After the end of the procedure, the gel is wiped off and the patient can leave the clinic. No special restrictions are required.
Most patients feel relief after the first session. But in some cases, on the contrary, there is an exacerbation of the pain syndrome, as a rule, it subsides after 2-3 procedures.To achieve maximum results, it takes about 5-7 sessions with an interval of 5-7 days.
In 85% of patients, it is possible to achieve complete relief of pain with only one SWT. In other cases, it is necessary to prescribe additional treatment, for example, drug therapy. Read more about UHT here.
Advantages of UVT
- Small list of contraindications: pregnancy, oncology, the presence of a pacemaker, blood clotting disorder.
- Well tolerated by patients.
- Highly effective.
- Treatment takes place on an outpatient basis and practically does not cause complications.
MLT for the treatment of heel pain
MLT is a physiotherapy method of treatment that combines exposure to a magnetic field and low-energy laser radiation. In this case, the action of both physical factors potentiates each other, which leads to an increase in the therapeutic effect:
- Decreases the severity of inflammatory processes.
- Pain syndrome is relieved.
- Regenerative processes are activated.
MLT is absolutely comfortably tolerated by patients. Pleasant warmth is felt during the session. No painful sensations. The technique is used as an independent treatment and in conjunction with other methods. Read more about MLT here.
Other causes of heel pain
In addition to plantar fasciitis, the following pathologies can cause heel pain:
- Injuries – fractures of the calcaneus, tendon sprains, etc.
- Arthritis and arthrosis, which can also affect the joints of the foot.
- Malignant bone tumors.
- Cracked heel.
- Dry calluses.
- Certain dermatological diseases.
In any case, if pain in the heel occurs, it is necessary to consult a doctor, who, after the necessary examination, will prescribe an adequate treatment. You do not need to endure pain and bring yourself to an incapacitating state. The problem is well solved by modern safe and affordable methods.
90,000 Calcaneal spur: description of the disease, causes, symptoms, cost of treatment in Moscow
A heel spur is an inflammation in the soft tissues of the calcaneal tuberosity. This syndrome is caused by a number of pathological abnormalities. In this condition, bone tissue grows and damages the surrounding tissue. The growth is located in the plantar part of the calcaneus. Sizes can be different, and the shape resembles a spur, beak or thorn.
Over the past decades, this disease has been diagnosed with greater intensity.The largest number of complaints are from middle-aged women. But all age categories are at risk, regardless of gender and lifestyle. Appears from a heavy load on the feet. In the early stages, the disease can be effectively cured. But the launched process of progression is quite difficult to cure. By old age, a heel spur can be found in 25% of the population.
Reasons for the formation
The appearance of a heel spur depends on a number of factors. It can be either acquired or congenital syndrome.Throughout life, when walking, the load falls on the area of occurrence of fasciitis. Infection, trauma, and vascular malfunction can also be the cause.
Consider a number of factors in the occurrence of spurs:
Overweight leads to increased stress on the foot.
All types of flat feet, as well as deformities caused during improper walking.
Violation of blood circulation in the body.
Elevated blood sugar.
After 50 years, the reduction of the fatty layer in the heel bone.
Defeat of nerve endings.
Severe injury to the heel, fracture.
Muscle strain and inflammation.
Diseases of the vertebra and joints.
Excessive physical stress on this area.
To avoid symptoms of heel spur disease, you should examine the entire body and begin treatment for other existing diseases. Against the background of these deviations from the norm, small tears appear in the tendons. Over time, this leads to inflammation. Healing is very slow. The inflammation spreads to the muscles and the area under the calcaneal tuberosity. A fluid is formed that slows down the healing process and disrupts blood flow. Salts are deposited on the hillock.A build-up begins to appear.
Heel pain is the main symptom of a heel spur. There may not even be any visual disturbances. In this case, a person feels pain of a different nature. Sometimes redness or an increase in body temperature is seen in the affected area. To begin effective treatment, you should study the symptoms and find out which disease caused the heel spur.
It is easy for a doctor to diagnose a heel spur.Based on the patient’s complaints about heel pain, the diagnosis is made immediately in 95% of cases. The doctor will examine the limb visually, and, thanks to pressure on certain points on the heel, accurately diagnose the disease. For confirmation, the patient is prescribed an X-ray, according to which the doctor will reveal the size and shape of the spur. Prescribe the correct treatment and assess the level of progression of the disease.
Over time, the growth can reach a size of more than 1 cm. It grows on the heel towards the toes.It can be diagnosed as a result of an X-ray of another area of the legs, and can be seen by a specialist. At the same time, in one patient, due to severe pain, movement may be limited, while the other does not experience any sensations.
Heel spur disease is often confused with a spine. These are completely different diseases that are located on different parts of the heel, and the treatment proceeds in different ways. Based on the X-ray photo, the doctor will determine the stage of the disease of the heel spur syndrome.At the first stage, a rounded shape is inherent. In the second stage, the spur changes shape and increases in size. In its neglected form, it becomes 12 mm in size and resembles a bird’s beak.
Additional examinations may include ultrasound examination of the heel spur and magnetic resonance imaging. To determine the damage and condition of soft tissues. Ultrasound is accompanied at all stages of treatment and therapy, to monitor the condition and the healing process.
To eliminate the swelling, stretch the tendons and relieve inflammation from the calcaneal tuberosity, medication or physiotherapy is prescribed.Ointments, tablets and compresses are prescribed, in which the pain when walking will begin to decrease. Modern medicine allows you to prescribe an effective course of treatment for heel spurs using special procedures:
Wearing heel prostheses.
There are various methods and treatments for heel spurs:
Ointments.Special anti-inflammatory and regenerating ointments help to restore cartilage tissue, restore tissue elasticity, and relieve pain. With correct and long-term use, edema disappears and the balance of minerals in the damaged area is regulated. The warming effect will improve blood circulation and heat exchange. The most common are: Voltaren, Chondroxide, Dexamethasone, Indomethacin.
Preparations. Medication focuses on blocking the chemicals that contribute to inflammation.Chondroprotectors can accelerate the recovery of bone and soft tissue. They will give elasticity and normalize blood circulation in the body. For example: Artadol, Ibuprofen, Diclofenac, Nise.
Injections. Appointed and performed only by a specialist. The correct dosage and penetration depth are determined. To relieve severe pain and speed of action, injections are performed 2-3 times a day.
Blockades. Heel shots are performed by the surgeon to block the spread of inflammation and pain.One correct block will help relieve pain for several years. A solution of ledocaine or novocaine is administered with an active substance such as Diprospan or Betamethasone.
Wave therapy. The most effective treatment. Has no side effects. The duration of the procedure is about half an hour. No pain.
Laser therapy. Laser treatment is the most painless and enjoyable treatment. The price matches the quality. A powerful laser beam penetrates the affected area and speeds up the metabolism.Daily procedures for 10-20 minutes, depending on the patient’s condition, are carried out 5-10 times.
Indications and course of operation
At the first sign of a heel spur, do not self-medicate and seek immediate medical attention. Surgery is rarely performed, but sometimes it becomes simply necessary. The effectiveness of removing bone growth through an incision in the skin brings results in 70% of cases, otherwise the pain returns.
1. Lack of improvement in the patient’s condition within six months.
2. The impossibility of waiting and carrying out drug treatment.
3. Decreased performance and limited movement.
During surgery, the doctor performs the following actions:
puts the patient into anesthesia;
makes an incision on the heel;
penetrates through the incision and removes the affected area of the fascia;
frees the nerve by dissecting the muscle tissue from the thumb;
removes the build-up;
the heel surface is leveled for further favorable healing;
muscles and nerves are in place;
sutures are applied;
seams are processed;
the patient is recovering from anesthesia.
Calcaneal spur – Foot – Treatment – Personal website of the orthopedist-traumatologist Sergey Yuryevich Dedov
HEEL SPUR (PLANTAR FASCIET)
Heel spur (plantar fasciitis) is a chronic condition characterized by pain in the heel when walking.
The pathogenesis of the disease is based on microdamage to the plantar aponeurosis (plantar fascia) in the zone of its fixation to the calcaneus.As a result of these injuries of the plantar ligament, local inflammation of the aponeurosis occurs, which is maintained daily due to the constant tension of the ligament when walking. It is a misconception that heel pain occurs as a result of stress on the heel spine. The very same bone exostosis (spur) on the plantar surface of the heel bone, as a rule, does not give pain, and is a consequence of chronic inflammation of the plantar aponeurosis. Therefore, it is more logical to talk about such a disease as heel fasciitis than about a heel spur.
The causes of plantar fasciitis (heel spurs) are longitudinal flat feet, overweight, hollow feet, wearing shoes with thin soles, seasonal change of shoes. In most cases, the disease occurs in people over 40 years of age. Athletes also have a predisposition to the development of heel spurs with prolonged overload of the heels.
Patients report intense sharp pain in the heel when walking. Platnar fasciitis (heel spur) is characterized by “starting pains”, i.e.e. morning pains or after prolonged sitting. During the day, the pain when walking subsides somewhat, and in the evening, an increase in the pain syndrome is possible.
The diagnosis of plantar fasciitis (heel spur) is made on the basis of clinical examination and radiological. Soreness is noted on palpation along the plantar surface of the heel. Sometimes these are diffuse pains throughout the heel, more often local pains in the center or along the inner surface of the heel region.
On the roentgenogram of the foot, a bony outgrowth in the form of a thorn along the plantar surface of the calcaneus is visualized, but sometimes this “bony thorn” is not detected on the roentgenogram.
Treatment of plantar fasciitis (heel spurs) is conservative. In the clinic, we carry out an integrated approach to the treatment of this disease.
GUTA-CLINIC was one of the first in Russia to start using shock wave therapy for the treatment of heel spurs, as well as other diseases of the musculoskeletal system (epicondylitis, tendoperiostopathy, etc.).
For 8 years, the clinic has been successfully using extracorporeal shock wave therapy (ERWT) using the Swiss Dolor Clast apparatus (EMS, Switzerland).
The method of shock wave therapy is based on the therapeutic effect of a radial mechanical wave, which allows for a short time to relieve pain in the heel area. The average course of therapy is 5 sessions with an interval of 5-7 days. The duration of the shock wave therapy session is 15-20 minutes. The treatment does not require anesthesia, there is no trauma to the skin and tissues, is well tolerated by patients, and there are no side effects.
Shockwave therapy apparatus Conducting shockwave therapy
Swiss Dollar Clast (EMS, Switzerland)
In “advanced” cases of the disease, along with shock wave therapy in order to relieve inflammation in the area of the “heel spur”, injections of corticosteroids are performed (Diprospan).Injections are carried out under local anesthesia (Lidocaine 2%), 1-2 injections are enough for a lasting effect.
The most important condition for the effectiveness of the treatment of plantar fasciitis (heel spur) is to ensure the unloading of the painful heel area with the help of special insoles. The clinic carries out the selection and modeling of individual orthopedic insoles-instep supports directly on the patient’s leg. These instep supports not only relieve the painful heel zone, but also prevent the appearance of plantar fasciitis (heel spur) on the other foot!