Introduction
Heel spurs are bony growths that form under or at the back of the heel. Rather than the spur itself, it is typically the surrounding inflammation that causes pain. Fortunately, most people find relief through non-surgical treatment methods.
Anatomy
The heel bone, known as the calcaneus, is essential in distributing body weight while standing or walking. It connects to soft tissues that shape and support foot movement. The plantar fascia, which forms the arch of the foot, is one such tissue that connects directly to the calcaneus.
Causes
Heel spurs often arise in people with plantar fasciitis, which is inflammation of the plantar fascia. This condition can cause the plantar fascia to pull away from the calcaneus, allowing calcium deposits to accumulate and form a spur at the inflammation site. Heel spurs are more common among middle-aged individuals, people with prolonged plantar fasciitis, and those with flat feet or high arches. Women who frequently wear high-heeled shoes are also at higher risk.
Symptoms
While heel spurs may not always produce symptoms, those that do are typically linked to plantar fasciitis. Pain often intensifies in the morning after waking up or during certain activities.
Diagnosis
A doctor will review your medical history and examine the foot to assess the condition. X-rays can be used to determine the spur’s size and location.
Treatment
Non-surgical treatments are the first line of action for heel spurs, typically resolving symptoms within three months to a year. Rest, ice, anti-inflammatory medications, and in some cases, cortisone injections can reduce pain. Doctors may also suggest stretching exercises and custom orthotics to cushion and position the heel properly. Night splints can support the arch and heel during sleep. For persistent cases, extracorporeal shock wave therapy (ESWT), which uses energy pulses to stimulate tissue repair, may be recommended.
Surgery
Surgery is rarely needed but may be considered after at least a year of non-surgical treatments. Plantar fascia release surgery, sometimes combined with tarsal tunnel release, can be effective in relieving pain for most patients.
Recovery
Recovery from non-surgical treatments can take several months up to a year. Many doctors advise trying these options for at least a year before exploring surgical alternatives.
Prevention
Preventative steps include wearing supportive shoes and using custom orthotics or insoles to alleviate pressure. Regular stretching exercises can also help maintain foot flexibility and prevent symptoms from returning.
