What to do about a bone spur. Bone Spurs: Causes, Symptoms, Diagnosis, Treatment, and Prevention Guide
What are the common causes of bone spurs. How can bone spurs be diagnosed effectively. What are the most effective treatments for bone spurs. How can bone spurs be prevented in daily life.
Understanding Bone Spurs: Formation and Common Locations
Bone spurs, also known as osteophytes, are smooth, hard protrusions of extra bone that develop on the ends of existing bones. These bony outgrowths often occur in joints where two bones meet. While they can form in various parts of the body, some common locations include:
- Hands
- Shoulders
- Neck
- Spine
- Hips
- Knees
- Feet (particularly the heels)
Do bone spurs always cause problems? Interestingly, most bone spurs don’t cause any issues. However, when they rub against other bones or press on nerves, they can lead to pain and stiffness.
The Root Causes of Bone Spur Formation
Understanding the underlying causes of bone spurs is crucial for effective prevention and treatment. The most common cause is joint damage resulting from osteoarthritis or degenerative joint disease. As we age, the cushioning between our joints and the bones of our spine can wear down, leading to bone spur formation.
Are there other conditions that can contribute to bone spur development? Indeed, several other factors can play a role:
- Autoimmune diseases: Rheumatoid arthritis, lupus, and gout can damage joints and trigger bone spur formation.
- Injuries: Bone spurs often develop after an injury to a joint or tendon. The body’s attempt to repair the damage can result in extra bone growth.
- Overuse: Repetitive activities like running or dancing over extended periods can lead to bone spur formation.
- Genetics: Some individuals may be genetically predisposed to developing bone spurs.
- Diet: Certain dietary factors may influence bone spur development, although more research is needed in this area.
- Obesity: Excess weight puts additional stress on joints, potentially contributing to bone spur formation.
- Congenital bone issues: Some people are born with bone problems that increase their likelihood of developing bone spurs.
- Spinal stenosis: Narrowing of the spine can sometimes lead to bone spur formation.
Recognizing the Symptoms of Bone Spurs
Identifying bone spur symptoms can be challenging, as they often go unnoticed until discovered during an X-ray for another condition. However, when bone spurs press on nerves, tendons, or other structures in the body, they can cause various symptoms:
- Pain in the affected joint
- Pain or stiffness when attempting to bend or move the affected joint
- Weakness, numbness, or tingling in the arms or legs (if the bone spur presses on spinal nerves)
- Muscle spasms, cramps, or weakness
- Visible bumps under the skin, particularly in the hands and fingers
- In rare cases, difficulty controlling bladder or bowels (if the bone spur presses on specific spinal nerves)
When do bone spur symptoms typically worsen? Symptoms often intensify during physical activity or when attempting to move the affected joint. In some cases, a bone spur can break off and become lodged in the joint lining, creating a “loose body” that can lock up the joint and restrict movement.
Diagnosing Bone Spurs: Medical Approaches and Imaging Techniques
The process of diagnosing bone spurs typically begins with an evaluation by a primary care physician. In many cases, patients are then referred to specialists such as rheumatologists (who focus on joint problems) or orthopedic doctors (who specialize in the musculoskeletal system).
What methods do doctors use to diagnose bone spurs? The diagnostic process often includes:
- Physical examination: The doctor will palpate the joint to check for any noticeable bumps or abnormalities.
- X-ray: This is the most common imaging technique used to visualize bone spurs.
- CT scan: A more powerful X-ray that provides detailed images of the internal structures.
- MRI: This technique uses powerful magnets and radio waves to create detailed images of organs and structures within the body.
- Electroconductive tests: These measure the speed at which nerves transmit electrical signals, helping to assess any damage caused by bone spurs in the spinal canal.
Effective Treatments and Home Care Strategies for Bone Spurs
The treatment of bone spurs aims to alleviate pain, reduce inflammation, and improve joint function. Several approaches can be employed, ranging from over-the-counter medications to surgical interventions:
Over-the-Counter Pain Relievers
Common pain relievers that can help manage bone spur discomfort include:
- Acetaminophen (Tylenol)
- Ibuprofen (Advil, Motrin)
- Naproxen sodium (Aleve)
It’s important to note that these medications can cause side effects, especially if taken in large doses or for extended periods. If you’ve been using them for more than a month, consult your doctor about alternative treatments.
Other Therapeutic Approaches
Additional treatments for bone spurs may include:
- Rest: Allowing the affected joint to rest can help reduce pain and inflammation.
- Steroid injections: These can help decrease swelling and alleviate pain in the affected joint.
- Physical therapy: This can improve joint strength and increase range of motion.
- Surgery: In cases where other treatments are ineffective or the bone spur significantly impairs movement, surgical removal of the extra bone may be necessary.
Preventive Measures: Reducing the Risk of Bone Spur Formation
While it’s not always possible to prevent bone spurs, especially those resulting from the natural wear and tear of arthritis, there are steps you can take to reduce your risk:
Footwear Considerations
- Choose shoes with a wide toe box, good arch support, and adequate cushioning.
- Have your shoes professionally fitted to prevent rubbing and friction.
- Wear thick socks to provide additional protection against shoe friction.
Lifestyle and Dietary Factors
- Maintain a balanced diet rich in calcium and vitamin D to support bone health.
- Engage in regular weight-bearing exercises like walking or stair climbing to strengthen bones.
- Manage your weight to reduce excess stress on joints.
- Seek medical attention promptly if you notice signs of joint trouble, such as pain, swelling, or stiffness.
Can early treatment of arthritis help prevent bone spurs? Yes, early diagnosis and treatment of arthritis may help prevent the joint damage that often leads to bone spur formation.
Advanced Diagnostic Techniques for Bone Spurs
As medical technology advances, new diagnostic techniques are emerging to complement traditional methods in identifying and assessing bone spurs:
High-Resolution Ultrasound
Ultrasound imaging can provide real-time visualization of soft tissues and bone surfaces, making it particularly useful for detecting bone spurs in superficial joints like those in the hands and feet. This non-invasive technique offers the advantage of being radiation-free and allows for dynamic assessment of joint movement.
Dual-Energy CT (DECT)
DECT is an advanced form of CT scanning that can differentiate between various types of tissues and materials. This technique can be particularly helpful in distinguishing bone spurs from other calcifications or joint abnormalities, providing more accurate diagnoses.
PET-CT Scans
While not commonly used for bone spur diagnosis, Positron Emission Tomography (PET) combined with CT scans can be valuable in cases where bone spurs are suspected to be associated with underlying inflammatory conditions or malignancies.
How do these advanced techniques enhance bone spur diagnosis? These methods offer higher sensitivity and specificity in detecting bone spurs, particularly in complex cases or when traditional imaging techniques yield inconclusive results.
Emerging Treatments and Future Directions in Bone Spur Management
The field of bone spur treatment is evolving, with researchers exploring new approaches to manage this condition more effectively:
Biological Therapies
Researchers are investigating the use of biological agents, such as growth factors and stem cells, to promote tissue repair and potentially prevent or reverse bone spur formation. These therapies aim to address the underlying causes of bone spurs rather than just treating the symptoms.
Targeted Drug Delivery Systems
Advanced drug delivery methods, such as nanoparticle-based systems, are being developed to target bone spurs more precisely. These systems could potentially deliver anti-inflammatory or bone-modulating drugs directly to the affected areas, minimizing systemic side effects.
Minimally Invasive Surgical Techniques
Advancements in surgical technology are leading to the development of less invasive procedures for bone spur removal. Techniques such as endoscopic surgery and robot-assisted procedures offer the potential for smaller incisions, faster recovery times, and reduced risk of complications.
Gene Therapy
Early-stage research is exploring the potential of gene therapy to modify the genetic factors that contribute to bone spur formation. This approach could potentially prevent bone spurs from developing in individuals with genetic predispositions.
What potential do these emerging treatments hold for bone spur management? While many of these approaches are still in the experimental stages, they offer hope for more effective and personalized treatments in the future, potentially revolutionizing the way we manage bone spurs.
The Impact of Bone Spurs on Quality of Life and Daily Activities
While many bone spurs remain asymptomatic, those that cause pain or functional limitations can significantly impact an individual’s quality of life and ability to perform daily activities:
Mobility and Physical Activity
Bone spurs in weight-bearing joints like the knees, hips, or feet can make walking, climbing stairs, or engaging in physical exercise challenging. This reduced mobility can lead to a more sedentary lifestyle, potentially contributing to other health issues.
Work Performance
Depending on their location, bone spurs can interfere with job-related tasks. For example, bone spurs in the hands might make typing or manual labor difficult, while spinal bone spurs could affect posture and comfort during prolonged sitting.
Sleep Quality
Pain from bone spurs, particularly those in the spine or hips, can disrupt sleep patterns. Poor sleep quality can, in turn, exacerbate pain perception and impact overall well-being.
Psychological Well-being
Chronic pain and functional limitations associated with bone spurs can lead to frustration, anxiety, or depression in some individuals. This emotional impact underscores the importance of comprehensive care that addresses both physical and psychological aspects of the condition.
How can individuals with bone spurs maintain their quality of life? Adopting a multifaceted approach that combines medical treatment, lifestyle modifications, and psychological support can help manage symptoms and maintain functionality. This may include:
- Working with a physical therapist to develop an exercise program that maintains joint flexibility and strength without exacerbating symptoms
- Using assistive devices when necessary to reduce strain on affected joints
- Exploring pain management techniques, including mindfulness and relaxation strategies
- Participating in support groups or counseling to address the emotional aspects of living with chronic pain
By understanding the potential impact of bone spurs on daily life and taking proactive steps to manage the condition, individuals can often maintain a good quality of life despite the challenges posed by this common orthopedic issue.
Causes, Symptoms, Diagnosis, Treatment, & Prevention
Written by WebMD Editorial Contributors
- What Are Bone Spurs?
- Causes of Bone Spurs
- Symptoms of Bone Spurs
- Bone Spur Diagnosis
- Bone Spur Treatments and Home Care
- Bone Spur Prevention
- More
Bone spurs (also called osteophytes) are smooth, hard bumps of extra bone that form on the ends of bones. They often pop up in the joints — the places where two bones meet.
Bone spurs can form on many parts of your body, including your:
- Hands
- Shoulders
- Neck
- Spine
- Hips
- Knees
- Feet (heels)
Most bone spurs don’t cause problems. But if they rub against other bones or press on nerves, you might experience pain and stiffness.
The most common cause of bone spurs is joint damage from osteoarthritis or degenerative joint disease. The cushioning between your joints and the bones of your spine can wear down with age. Rheumatoid arthritis, lupus, and gout can also damage your joints.
Bone spurs also often form after an injury to a joint or tendon. When your body thinks your bone is damaged, it tries to fix it by adding bone to the injured area.
Other causes of bone spurs include:
- Overuse – for example, if you run or dance a lot over a long period of time
- Genes
- Diet
- Obesity
- Bone problems that you were born with
- Narrowing of the spine (spinal stenosis)
You might not realize you have a bone spur until you get an X-ray to look for another condition. They only cause problems when they press on nerves, tendons, or other structures in your body. Then, you might feel any of the following:
- Pain in the affected joint
- Pain or stiffness when you try to bend or move the affected joint
- Weakness, numbness, or tingling in your arms or legs if the bone spur presses on nerves in your spine
- Muscle spasms, cramps, or weakness
- Bumps under your skin, seen mainly in the hands and fingers
- Trouble controlling your bladder or bowels if the bone spur presses on certain nerves in your spine (a symptom that’s seen very rarely)
Your symptoms might get worse when you exercise or try to move the affected joint.
A bone spur can break off and get stuck in the lining of the joint. This is called a “loose body.” It can lock up the joint and make it hard to move.
Often, bone spurs are first evaluated by your regular doctor who will likely refer you to a specialist. You’ll probably need to see a rheumatologist or orthopedic doctor. Rheumatologists specialize in joint problems. Orthopedic doctors focus on the musculoskeletal system. Your doctor will feel the joint to check for a bump. They may also order an X-ray to help them to see the bone spur better.
Other tests your doctor can use to diagnose bone spurs include:
- CT scan. It’s a powerful X-ray that makes detailed pictures inside your body.
- MRI. This uses powerful magnets and radio waves to make pictures of organs and structures inside your body.
- Electroconductive tests. These tests measure how fast your nerves send electrical signals. They can show the damage bone spurs have caused to nerves in your spinal canal.
To relieve pain and bring down swelling, you can try one of these over-the-counter pain relievers:
- Acetaminophen (Tylenol)
- Ibuprofen (Advil, Motrin)
- Naproxen sodium (Aleve)
These can cause side effects, especially if you take them in large doses or for a long time. If you’ve taken them for more than a month, ask your doctor if you can try a different treatment.
Other therapies for bone spurs include:
- Rest
- Steroid shots to bring down swelling and reduce pain in the joints
- Physical therapy to improve joint strength and increase movement
If these treatments don’t work or the bone spur affects your movement, you might need surgery to remove the extra bone.
Bone spurs usually can’t be prevented if they’re the result of the natural wear and tear of arthritis. But you can take these steps to avoid bone spurs caused by other things:
- Wear shoes with a wide toe box, good arch support, and enough cushion to pad each step. Get your shoes fitted by a professional so they don’t rub against your feet when you walk. Wear thick socks to prevent your shoes from rubbing.
- Eat a well-rounded diet with plenty of calcium and vitamin D to protect your bones.
- Do regular weight-bearing exercises like walking or stair climbing to keep your bones strong.
- Try to keep the extra pounds off.
See your doctor if you have any signs of joint trouble, like pain, swelling, or stiffness. If you catch and treat arthritis early, you may be able to prevent the damage that leads to bone spurs.
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Causes, Symptoms, Diagnosis, Treatment, & Prevention
Written by WebMD Editorial Contributors
- What Are Bone Spurs?
- Causes of Bone Spurs
- Symptoms of Bone Spurs
- Bone Spur Diagnosis
- Bone Spur Treatments and Home Care
- Bone Spur Prevention
- More
Bone spurs (also called osteophytes) are smooth, hard bumps of extra bone that form on the ends of bones. They often pop up in the joints — the places where two bones meet.
Bone spurs can form on many parts of your body, including your:
- Hands
- Shoulders
- Neck
- Spine
- Hips
- Knees
- Feet (heels)
Most bone spurs don’t cause problems. But if they rub against other bones or press on nerves, you might experience pain and stiffness.
The most common cause of bone spurs is joint damage from osteoarthritis or degenerative joint disease. The cushioning between your joints and the bones of your spine can wear down with age. Rheumatoid arthritis, lupus, and gout can also damage your joints.
Bone spurs also often form after an injury to a joint or tendon. When your body thinks your bone is damaged, it tries to fix it by adding bone to the injured area.
Other causes of bone spurs include:
- Overuse – for example, if you run or dance a lot over a long period of time
- Genes
- Diet
- Obesity
- Bone problems that you were born with
- Narrowing of the spine (spinal stenosis)
You might not realize you have a bone spur until you get an X-ray to look for another condition. They only cause problems when they press on nerves, tendons, or other structures in your body. Then, you might feel any of the following:
- Pain in the affected joint
- Pain or stiffness when you try to bend or move the affected joint
- Weakness, numbness, or tingling in your arms or legs if the bone spur presses on nerves in your spine
- Muscle spasms, cramps, or weakness
- Bumps under your skin, seen mainly in the hands and fingers
- Trouble controlling your bladder or bowels if the bone spur presses on certain nerves in your spine (a symptom that’s seen very rarely)
Your symptoms might get worse when you exercise or try to move the affected joint.
A bone spur can break off and get stuck in the lining of the joint. This is called a “loose body.” It can lock up the joint and make it hard to move.
Often, bone spurs are first evaluated by your regular doctor who will likely refer you to a specialist. You’ll probably need to see a rheumatologist or orthopedic doctor. Rheumatologists specialize in joint problems. Orthopedic doctors focus on the musculoskeletal system. Your doctor will feel the joint to check for a bump. They may also order an X-ray to help them to see the bone spur better.
Other tests your doctor can use to diagnose bone spurs include:
- CT scan. It’s a powerful X-ray that makes detailed pictures inside your body.
- MRI. This uses powerful magnets and radio waves to make pictures of organs and structures inside your body.
- Electroconductive tests. These tests measure how fast your nerves send electrical signals. They can show the damage bone spurs have caused to nerves in your spinal canal.
To relieve pain and bring down swelling, you can try one of these over-the-counter pain relievers:
- Acetaminophen (Tylenol)
- Ibuprofen (Advil, Motrin)
- Naproxen sodium (Aleve)
These can cause side effects, especially if you take them in large doses or for a long time. If you’ve taken them for more than a month, ask your doctor if you can try a different treatment.
Other therapies for bone spurs include:
- Rest
- Steroid shots to bring down swelling and reduce pain in the joints
- Physical therapy to improve joint strength and increase movement
If these treatments don’t work or the bone spur affects your movement, you might need surgery to remove the extra bone.
Bone spurs usually can’t be prevented if they’re the result of the natural wear and tear of arthritis. But you can take these steps to avoid bone spurs caused by other things:
- Wear shoes with a wide toe box, good arch support, and enough cushion to pad each step. Get your shoes fitted by a professional so they don’t rub against your feet when you walk. Wear thick socks to prevent your shoes from rubbing.
- Eat a well-rounded diet with plenty of calcium and vitamin D to protect your bones.
- Do regular weight-bearing exercises like walking or stair climbing to keep your bones strong.
- Try to keep the extra pounds off.
See your doctor if you have any signs of joint trouble, like pain, swelling, or stiffness. If you catch and treat arthritis early, you may be able to prevent the damage that leads to bone spurs.
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Treatment Heel “spur” – Orthopedics Ruslana Sergienko
A heel spur is the result of plantar fasciitis, the main symptom of which is pain in the heel that occurs or worsens with exercise. In most cases, the pain syndrome is caused by inflammatory and degenerative changes in the plantar (plantar) fascia.
Plantar fascia is a tough tendon plate, woven from a huge amount of microfibers, which is attached to the calcaneus and metatarsal heads, creating a kind of protective cover for the plantar surface of the foot.
As can be seen from the figure, the plantar fascia is stretched like a bowstring between the bones, the so-called arch of the foot. Imagine that with every step this kind of bowstring is pulled, holding this arch, preventing the bones of the foot from “parting”.
Constant load of body weight, overload during hard work, changes in posture due to diseases of the back lead to the appearance of microdamages in the places of attachment of the plantar fascia to the bones. As can be seen from the figure, the place of attachment of the “string” to the metatarsal bones is divided into five points, while on the heel there is only one point of attachment. The load is 5 times more on the heel, so the disease starts from the heel.
There is a microdamage (tear or rupture) of one of the many thin fibers of the plantar fascia. The body reacts in a standard way – inflammation develops. Inflammation leads to the formation of edema, abnormal germination of microvessels and small nerve branches into the damaged fascia, and pain occurs. The pain is especially severe after a night’s sleep and rest, the so-called “starting pain”.
The fibers of the plantar fascia that have remained intact begin to work instead of the broken ones, experiencing an increased load, and are also damaged.
Inflammation and pain progress, forcing to reduce the load. Human activity is reduced, new fibers are not damaged. The inflammatory process subsides, scars form at the site of the damaged fibers, and then bone growths that are visible on the x-ray and have a characteristic “spur” appearance.
That is why this disease is called “heel spur”, although the “spur” itself is already the result of long-term plantar fasciitis.
Who is more likely to suffer from heel spurs?
Heel spurs mainly affect people over 40 years of age, and women are more predisposed to this disease. The likelihood of developing heel spurs is increased by excess weight, problems with the spine, arthritis, flat feet, diseases of the large joints of the legs, injuries of the calcaneus, gout, circulatory disorders in the legs. Also, the heel spur is found in athletes with prolonged loads in the heel area.
What are the symptoms of a heel spur?
The leading symptom of heel spurs (plantar fasciitis) is pain in the heel region that occurs or worsens with exercise. Pain is more pronounced in the morning. In most cases, the diagnosis of plantar fasciitis is sufficient to analyze the patient’s complaints, physical examination and X-ray, which reveal the presence of a heel spur. The absence of radiological signs of a heel spur in combination with heel pain requires a differential diagnosis with systemic inflammatory diseases (rheumatoid arthritis, Reiter’s syndrome, etc. ), which can also debut with heel pain. In this case, the diagnosis of plantar fasciitis can be established using an ultrasound examination.
What is the treatment for heel spurs?
First, get rid of overloads.
This does not mean completely abandoning any movement. This means that a painless range of motion should be performed. For example, you have noticed that it is worth standing for 2 hours, the pain increases. Try to stand for 2 hours with breaks, for example 15 minutes. Or you walk 4 kilometers and experience pain. Try to walk 2 kilometers or the same 4 kilometers, but at a slow pace. Sports doctors have proven that continuing exercise in a “sparing mode” has a greater effect on the result of treatment than refusing to exercise at all.
Stretching and strengthening.
The stretching and strengthening program plays an important role in the treatment of the disease, as it can effectively relax cramped calf muscles or strengthen weak foot muscles. Why stretching or “stretching” is effective? It loosens the tension and reduces the risk of breaking the “bowstring”. A less taut plantar fascia is not damaged as much. Do these exercises at home.
The easiest way to stretch is using a support wall: Or steps: Another effective stretching method is to use footrests that can be used in the workplace, such as under a desk or in the kitchen, thus increasing the time for such “on-the-job” activities. . The use of “rocking chairs”, widely used to prevent salt deposits, is a type of “dynamic stretching” of the plantar fascia. For the same purpose, you can use a tennis ball or an iron can: Before getting out of bed, it is useful to perform a massage in the sole area to reduce pain:
or stretching with a towel: Strengthening the small muscles of the foot.
By performing 2 simple exercises, you can achieve a significant increase in strength in the small muscles of the foot, which will lead to unloading of the plantar fascia.
- Pull up towel. The patient sits on a chair, the towel lies on the smooth floor in front of him. The patient puts his toes on the towel and, without taking his heel off the floor, bending his toes, pulls the towel towards him.
- Finger up. The patient sits on a chair, the foot is placed on the floor, the toes are raised up. First, the thumb is placed on the floor, and the rest remain raised. Then the thumb is raised and remains in this position, and the rest are lowered and placed on the floor.
About 35% of patients achieve regression of symptoms only with the help of stretching and muscle strengthening.
Shoes.
It is not uncommon for plantar fasciitis to develop after wearing uncomfortable, especially tight shoes or shoes with excessively hard soles. People who suffer from plantar fasciitis may find that wearing sneaker-type shoes with soft, springy soles and an insole that hugs the arch of the foot significantly reduces pain. This is not surprising. The springy outsole absorbs impact when walking, while the arch-fitting insole supports it and transfers the load directly to the bones, bypassing the plantar fascia.
It should also be noted that over time, the properties of the polymeric materials from which shoes are made change, so such shoes need to be changed in a timely manner.
Insoles.
As far as insoles are concerned, it can be said that only custom-made devices, made on the basis of modern equipment based on the footprint, can help in the treatment of fasciitis. The insoles do not act on the fasciitis itself, but by correcting violations of the arch of the foot, for example, with flat feet. Incorrectly selected insoles can worsen the patient’s condition.
Night immobilizing dressings.
The purpose of immobilization bandages is to keep the ankle joint in a neutral position. It is noted that the vast majority of people sleep with outstretched socks. In this position, the places of attachment of the plantar fascia to the bones come together, which causes it to shorten over time. This is what causes morning pain in the foot. The person spent the whole night with outstretched socks, and in the morning he gets on his feet, sharply stretching the inflamed plantar fascia. The immobilizing bandage keeps the bones from coming together, and the plantar fascia does not contract overnight, which reduces morning pain.
An overnight immobilizing dressing can be made from plaster or polymeric bandages, or you can buy ready-made ones from those sold in a pharmacy.
An example of a nightly immobilizing bandage: Of course, sleeping in a cast is not very comfortable, but studies have shown that this method is effective in 80% of patients. Night immobilizing dressings are especially effective in patients with a long period of the disease (about 12 months or more).
Anti-inflammatory treatment of heel spurs.
Anti-inflammatory treatment of heel spurs includes ice, NSAIDs, electrophoresis and hormonal injections.
Ice is used in the form of ice massages, ice baths or ice packs.
Ice massage: the patient takes an ice cube, places it over the area of pain and performs circular movements with slight pressure for 5 to 10 minutes.
Ice bath: fill a shallow container with ice water, place only the heel in it and hold for 10 to 15 minutes. Do not lower other parts of the foot into the water to avoid hypothermia.
Ice pack: Place crushed ice in a plastic bag, wrap in a towel and apply to the heel for 15 to 20 minutes. Instead of crushed ice, you can use a bag of frozen food.
Ice is applied after completion of exercise or after a working day.
Non-steroidal anti-inflammatory drugs (eg diclofenac or nimesulide).
Non-steroidal anti-inflammatory drugs have been studied for plantar fasciitis with conflicting results. Therefore, they are recommended only in case of increased pain, given the side effects of these drugs, which include gastrointestinal bleeding, gastritis, damage to kidney tissue.
Electrophoresis.
Electrophoresis is a physiotherapy procedure that uses the properties of low voltage electrical impulses to deliver corticosteroid (hormonal) drugs deep into tissues. Studies of the effectiveness of this treatment method showed that within 2-3 weeks after the end of the procedure, the therapeutic effect decreases.
Corticosteroid injections.
Corticosteroid injections are effective in up to 70% of patients, but are known to rupture the plantar fascia in up to 10% of patients. It is known that the introduction of corticosteroids into any tissue leads to its death at the injection site. Therefore, this method of treatment should be used with extreme caution.
Shock wave therapy is a highly effective non-surgical method of treating heel spurs, approved by the equivalent of the US Department of Health as the main one for this particular disease, based on the action of acoustic shock waves. The method of shock wave therapy has been used for a long time to crush stones in the urinary tract. This is the so-called intracorporeal (conducted inside the body) shock wave therapy. Unlike devices for crushing kidney stones (lithotripters), in devices for extracorporeal (used on the surface of the body) shock wave therapy, the acoustic wave is much less powerful. Its action is based on the stimulation of regenerative processes in areas of chronic tendon inflammation and nonunion fractures.
Shock wave therapy does not break up heel spurs as is commonly believed. It sharply enhances regeneration at the site of damage to the plantar fascia, stops long-term inflammation, thereby, on the contrary, preventing the development of heel spurs. The shock wave in orthopedics does not destroy, but restores.
The effectiveness of shock wave therapy is comparable to surgical treatment, since more than 93% of patients report a pronounced and persistent clinical effect. However, unlike surgical treatment, shock wave therapy is a painless method of treatment that does not require anesthesia and the patient’s stay in the hospital.
Shock wave therapy is a safe method of treating heel spurs, it has a complex effect and eliminates the cause of the heel spur.
Effects of shock wave therapy:
- reduction of pain and inflammation
- improvement of blood circulation and nutrition of damaged tissues
- destruction of calcifications, bone “growths”
- accelerate the healing of damaged tissues
- increased mobility in the injured area of the body
- increasing the resistance of tendons, ligaments and muscles to physical stress and injury
Advantages of shock wave therapy:
- high clinical efficiency – up to 93% of patients have a clinical effect
- rapid onset of clinical effect – reduction of pain, swelling, improvement of mobility
- stable clinical effect of the course lasts up to 1 year
- patient safety – no complications or side effects
- convenience of treatment for the patient – the session lasts 5-10 minutes, the frequency of the procedure is 1 time per week, 5-7 sessions are enough for a complete recovery
- reduction in the need for drugs or complete elimination of them
- is an optimal replacement for surgery and injections.
It is recommended to support the effect of shock wave with stretching and muscle strengthening exercises, anti-inflammatory treatment in the form of ice and electrophoresis, as well as modification of the load regimen.
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Heel spur, causes, symptoms, treatment
Heel spur is a bony growth in the area of the plantar surface of the calcaneus. Its appearance is associated with constant irritation of the place of attachment to the heel bone of the plantar aponeurosis. This irritation usually occurs with increased physical exertion on the foot.
The main cause of bone outgrowth in the calcaneal region is the constant irritation of the place of attachment to the bone of the tendons or ligaments, in particular, the plantar aponeurosis. As a result of constant irritation in this area, inflammation occurs. That is what is causing the pain. Gradually, the place of attachment of the inflamed ligament or aponeurosis undergoes “calcification” – that is, as if “impregnated” with calcium salts. In this period, when radiography of the foot, you can see the shadow of the bone growth – osteophyte .
Major risk factors for heel spurs :
- Age over 40 years.
- Comorbidities in the joints of the foot, such as osteoarthritis or rheumatoid arthritis.
- Violation of blood microcirculation in the foot.
- Other degenerative diseases.
Symptoms of a heel spur
Symptoms of a heel spur do not appear immediately after the formation of a bone growth. Due to the proximity of the tendons, a heel spur can cause constant pain in the foot. Heel spur pain is described as similar to toothache.
It should be noted that the pain of a heel spur is not due to the pressure of body weight on the spur itself, but due to inflammation of the soft tissues around the spur. The pressure of these inflamed tissues, for example, when stepping on the heel, leads to sharp pains. Usually, pain most often occurs at the very beginning of walking. This is explained as follows. At rest, the nerves and capillaries in the area of the inflamed tissue, as it were, adapt to the rest of the foot. However, with a sharp start of movement, the vessels and nerves do not have time to adapt to new conditions. As a result, pain occurs.
Diagnosis
Performed by routine inspection and feel of the sole and heel. At the same time, the most painful point is located. The spur itself is usually not palpable, however, due to chronic inflammation of the soft tissues, their compaction can develop, which can be felt.
X-ray of the foot allows to clarify the diagnosis. In this case, the bone growth is visible on the x-ray.
Heel spur treatment
Treatment of a heel spur often is carried out conservatively and is aimed at three main points:
- Elimination of inflammation of the soft tissues around the spur;
- Prevention of inflammation;
- Elimination of the heel spur itself.
Patients come to the Orthopedics and Sports Injury Clinic of the Zaporozhye Regional Hospital with different problems, but with the same goal – to move freely again without pain and enjoy life. Natalya Borisovna from the Tokmak region was deprived of this happiness by a heel spur.
A woman says that she has suffered from heel spurs for years. I tried to defeat inflammation with the help of physiotherapy, all kinds of medicines and folk remedies, but they did not solve the problem, but only dulled the pain in the joint. Own house in the village, household, work – it became more and more difficult to live in the same rhythm. One day, Natalia Borisovna was suggested to go to the Orthopedics and Sports Injury Clinic , one of the best in Ukraine.
After consultation, the diagnosis of heel spur » was confirmed – the bone growth was clearly visible on the x-ray. At the appointment, the specialists of the clinic explained to the woman that the methods she had hoped for were effective only at the very beginning of the disease. And since Natalya Borisovna’s heel spur has been preventing her from living a normal life for years, the operation was the only right decision. Moreover, it was by no means impossible to delay the intervention.
“The patient needed to have her spur removed as soon as possible. She was at high risk of tearing her Achilles tendon where it attaches to her calcaneus. If we had not carried out the treatment, the growths would have become more and more. Therefore, in order to prevent a complex and risky operation to restore the Achilles tendon, we decided not to waste time and remove the spur,” comments Ivan Zabelin, head of the Orthopedics and Sports Injury Clinic.
Rengen-Directs before the Operation of the X-ray of the foot after surgery
During the intervention of the orthopedist of the clinic using low-traumatic techniques, they removed the resulting growth, so now nothing will prevent Natalia Borisovna to move normally. The patient is now feeling much better and is already planning treatment for a heel spur on her second leg.