What Are The Signs And Symptoms Of Calcaneal Spur

Overview

A heel spur is a bony projection on the sole (bottom) of the heel bone. This condition may accompany or result from severe cases of inflammation to the structure called plantar fascia. The plantar fascia is a fibrous band of connective tissue on the sole of the foot, extending from the heel to the toes. Heel spurs are a common foot problem resulting from excess bone growth on the heel bone. The bone growth is usually located on the underside of the heel bone, and may extend forward toward the toes. A painful tear in the plantar fascia between the toes and heel can produce a heel spur and/or inflammation of the plantar fascia. Because this condition is often correlated to a decrease in the arch of the foot, it is more prevalent after the ages of six to eight years, when the arch is fully developed.

Causes

Faulty foot structures such as abnormal growths, different leg lengths, and unhealed injuries and haveinf flat feet or high arches. Muscle imbalances tight, weak or shortened muscles in your foot, plantar fascia, ankle, calf and hamstring. Over pronation can cause imbalance in foot mechanics which puts excess pressure on the plantar fascia. Poor biomechanics affect the way your foot hits the ground. If you overpronate (feet roll inward) you tend to have flat feet (pes planus), which increases stress on the heel bone. Regular shoes or high heels that are too tight or don't support your heel or arch affect the distribution of your body weight on your foot. Health conditions such as obesity, inflammatory diseases (rheumatoid arthritis, ankylosing spondylitis), bursitis, neuroma (nerve growths), gout, diabetes, Haglund's deformity, and Achilles tendinitis can also instigate the problem. Running or jogging on hard surfaces, repetative striking of the heel bone.



Symptoms

The vast majority of people who have heel spurs feel the asscociated pain during their first steps in the morning. The pain is quite intense and felt either the bottom or front of the heel bone. Typically, the sharp pain diminishes after being up for a while but continues as a dull ache. The pain characteristically returns when first standing up after sitting for long periods.

Diagnosis

Sharp pain localized to the heel may be all a doctor needs to understand in order to diagnose the presence of heel spurs. However, you may also be sent to a radiologist for X-rays to confirm the presence of heel spurs.

Non Surgical Treatment

Diathermy treatment uses an electrical current to produce heat that sedates the inflamed tissues. The ultrasound device sends sound waves into the heel and sets up a massaging action that stimulates blood circulation. Treatment with a whirlpool bath involves placing the foot directly into the jetting stream. Orthopedic molds and appliances, such as orthotics, are designed by foot specialists for use inside the shoe to eliminate irritation to the heel when the patient stands or walks. When those appliances are used, the spur (in effect) floats on air. At the same time, the body's weight is transferred forward from the tender spot.

Surgical Treatment

Approximately 2% of people with painful heel spurs need surgery, meaning that 98 out of 100 people do well with the non-surgical treatments previously described. However, these treatments can sometimes be rather long and drawn out, and may become considerably expensive. Surgery should be considered when conservative treatment is unable to control and prevent the pain. If the pain goes away for a while, and continues to come back off and on, despite conservative treatments, surgery should be considered. If the pain really never goes away, but reaches a plateau, beyond which it does not improve despite conservative treatments, surgery should be considered. If the pain requires three or more injections of "cortisone" into the heel within a twelve month period, surgery should be considered.