Heel spurs, also known as calcaneal spurs are bony outgrowths that can develop on the bottom of the heel bone (calcaneus) often result from repetitive stress or strain on the foot, leading to inflammation and the formation of a spur over time. Heel spurs can cause pain and discomfort, especially when walking or standing. Treatment typically involves rest, physical therapy, orthotic devices, pain medication, and in some cases, surgery. It's important to consult with a healthcare professional for an accurate diagnosis and appropriate treatment plan.
They are often associated with a condition called plantar fasciitis, which is inflammation of the plantar fascia, a thick band of tissue that runs along the bottom of the foot from the heel to the toes.
The development of heel spurs is generally linked to repetitive stress or strain on the foot. This can be caused by various factors, such as:
Plantar fasciitis: When the plantar fascia becomes inflamed and tight, it can pull on the heel bone, leading to the formation of a spur over time.
Overuse or repetitive activities: Activities that involve repetitive pounding on the feet, such as running or jumping, can put excessive strain on the heel, leading to the development of a heel spur.
Poor biomechanics: Structural abnormalities or improper foot mechanics, such as flat feet or high arches, can contribute to the development of heel spurs by altering the distribution of weight and pressure on the foot.
Footwear: Wearing shoes that lack proper arch support or have worn-out soles can increase the risk of developing heel spurs.
Heel spurs themselves may not necessarily cause pain. However, they can lead to discomfort and pain when they irritate or press against nearby soft tissues, such as the plantar fascia or nerves in the area. The pain is typically localized to the bottom of the heel and may worsen with weight-bearing activities like walking or standing for prolonged periods.
Diagnosis of heel spurs usually involves a physical examination and medical history review. X-rays or other imaging tests may be ordered to confirm the presence of a spur and rule out other possible causes of heel pain.
Treatment for heel spurs often involves a combination of conservative measures, including:
Rest and activity modification: Avoiding activities that worsen the pain and giving the foot time to heal.
Physical therapy: Stretching and strengthening exercises to improve flexibility and reduce strain on the plantar fascia.
Orthotic devices: Custom-made shoe inserts (orthotics) or heel pads can provide cushioning and support to alleviate pressure on the heel.
Medications: Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) may help reduce pain and inflammation. In some cases, corticosteroid injections may be recommended for severe pain and inflammation.
Footwear modifications: Choosing supportive shoes with good arch support and cushioning can help relieve symptoms and prevent further aggravation.
Extracorporeal shock wave therapy (ESWT): This noninvasive procedure uses sound waves to stimulate healing and reduce pain.
Surgery: In rare cases when conservative measures fail to provide relief, surgical intervention may be considered to remove the spur or release the tension on the plantar fascia.
It's important to note that heel spurs may not necessarily be the primary cause of heel pain. Other conditions like Achilles tendinitis, bursitis, or nerve impingements can also contribute to heel discomfort. Consulting with a healthcare professional, such as a podiatrist, can help determine the underlying cause of the pain and guide appropriate treatment.
How do I know if I have plantar fasciitis or heel spurs?
Determining whether you have plantar fasciitis or heel spurs typically requires a medical evaluation by a healthcare professional, such as a podiatrist. However, there are some common signs and symptoms that can help differentiate between the two conditions:
Plantar Fasciitis:
Heel pain: The most prominent symptom of plantar fasciitis is pain in the bottom of the heel. The pain is often described as a sharp, stabbing sensation that is worse in the morning or after periods of rest.
Pain with the first steps: Pain is typically more intense with the first steps taken after waking up or getting up from a seated position.
Pain improvement with activity: Pain may lessen as the foot warms up and becomes more limber with movement, but it can worsen again after prolonged activity.
Tenderness: The bottom of the heel may be tender to the touch.
Tightness or stiffness: Many individuals with plantar fasciitis experience tightness or stiffness in the calf muscles or the plantar fascia itself.
Heel Spurs:
Heel pain: Similar to plantar fasciitis, heel spurs can cause pain in the bottom of the heel. The pain is often described as a dull ache or tenderness.
Occasional symptoms: Not everyone with heel spurs experiences pain. Some individuals may have heel spurs incidentally discovered during X-rays for other foot-related issues.
Associated conditions: Heel spurs are often seen in conjunction with plantar fasciitis, as the excessive tension and inflammation of the plantar fascia can lead to the formation of spurs.
It's important to note that plantar fasciitis and heel spurs can coexist, and the presence of a heel spur does not necessarily mean that it is the primary cause of your symptoms. To receive an accurate diagnosis, it is recommended to consult with a healthcare professional who can evaluate your symptoms, perform a physical examination, and order any necessary imaging tests, such as X-rays or ultrasound, to determine the underlying cause of your heel pain.
What makes heel spurs worse?
Several factors can contribute to making heel spurs worse or exacerbating the associated symptoms. These factors include:
Weight-bearing activities: Activities that put significant stress on the feet, such as running, jumping, or prolonged standing, can increase pain and inflammation associated with heel spurs.
Improper footwear: Wearing shoes that lack proper arch support or cushioning can worsen heel spur symptoms. High heels, worn-out shoes, or shoes that do not provide adequate shock absorption can aggravate the condition.
Excessive weight or obesity: Carrying excess body weight puts additional strain on the feet and can exacerbate heel spur pain and discomfort.
Poor biomechanics: Structural abnormalities in foot mechanics, such as flat feet or high arches, can contribute to increased pressure and strain on the heel, making heel spurs worse.
Lack of rest or overuse: Not allowing sufficient time for rest and recovery can prolong and intensify heel spur symptoms. Continuous overuse or repetitive activities without giving the foot time to heal can exacerbate the condition.
Inadequate stretching or flexibility exercises: Tightness and lack of flexibility in the calf muscles and the plantar fascia can contribute to increased strain on the heel, making heel spurs worse. Failing to perform regular stretching exercises can impede healing and aggravate symptoms.
Ignoring treatment: Delaying or neglecting appropriate treatment measures, such as physical therapy, orthotic devices, or pain management techniques, can lead to a worsening of heel spur symptoms.
It is important to address these factors and modify your activities and lifestyle accordingly to reduce stress and pressure on the heel. Following a comprehensive treatment plan recommended by a healthcare professional, which may include rest, physical therapy, footwear modifications, and other interventions, can help manage and alleviate heel spur symptoms.