Overview
The calcaneus is the largest bone in the foot. Pain in the heel region can sometimes be related to Plantar Fasciitis, inflammation of the plantar fascia ligament in the heel area. A heel spur is a hook of bone that forms on the calcaneus where the plantar fascia attaches. Heel spurs can be identified with an X-ray. A heel spur can occur with or without Plantar Fasciitis.
Causes
Common causes of this bone spur in the heel are repetitive trauma to the base of the heel, obesity, poor walking/running technique, poorly fitting shoes, or hereditary conditions.
Symptoms
An individual with the lower legs turning inward, a condition called genu valgus or "knock knees," can have a tendency toward excessive pronation. This can lead to a fallen arch and problems with the plantar fascia and heel spurs. Women tend to suffer from this condition more than men. Heel spurs can also result from an abnormally high arch. Other factors leading to heel spurs include a sudden increase in daily activities, an increase in weight, or a thinner cushion on the bottom of the heel due to old age. A significant increase in training intensity or duration may cause inflammation of the plantar fascia. High-heeled shoes, improperly fitted shoes, and shoes that are too flexible in the middle of the arch or bend before the toe joints will cause problems with the plantar fascia and possibly lead to heel spurs.
Diagnosis
Your doctor will review your medical history and examine your foot. X-rays are used to identify the location and size of the heel spur.
Non Surgical Treatment
In many cases treatment is non-surgical and can relieve pain, but may take from three months to a year to fully recover. Performing stretching exercises to help relax the tissues in the heel as well as rest, icing, and over-the-counter anti-inflammatory or prescription medications can help ease symptoms. Customized orthotics or shoe inserts to position and cushion your heel can help.
Surgical Treatment
In a small number of cases (usually less than 5 percent), patients may not experience relief after trying the recommendations listed above. It is important that conservative treatments (such as those listed above) be performed for AT LEAST a year before considering surgery. Time is important in curing the pain from heel spurs, and insufficient treatment before surgery may subject you to potential complications from the procedure. If these treatments fail, your doctor may consider an operation to loosen the plantar fascia, called a plantar fascia release.
Prevention
You can prevent heel spurs by wearing well-fitting shoes with shock-absorbent soles, rigid shanks, and supportive heel counters; choosing appropriate shoes for each physical activity; warming up and doing stretching exercises before each activity; and pacing yourself during the activities. Avoid wearing shoes with excessive wear on the heels and soles. If you are overweight, losing weight may also help prevent heel spurs.