A heel spur is a pointed bony outgrowth of the bone of the heel (the calcaneus bone). Heel spurs under the sole of the foot (plantar area) are associated with plantar fasciitis. Heel spurs and
plantar fasciitis can occur alone or be related to underlying diseases. Heel spurs and plantar fasciitis are treated by measures that decrease the associated inflammation and avoid reinjury.
Causes for heel spurs (and related plantar fasciitis) include increase or change in activity, lack of arch support or poor shoe choice, injury, inflexibility in Achilles tendon and calf muscles, and
spending hours daily on the feet. Also, arthritis from aging is often a common cause of bone loss and natural cushioning under the heel. Tarsal tunnel syndrome can also be to blame. Ultimately, in
the United States, the most likely cause of this pain is being overweight. With more than 60% of the nation obese or morbidly obese, foot pain related to excessive weight is most likely. Dietary
changes are most likely to cause long-term relief for bone spurs and plantar fasciitis.
The Heel Spur itself is not thought to be painful. Patients who experience pain with Plantar Fasciitis are suffering from inflammation and irritation of the plantar fascia. This the primary cause of
pain and not the Heel Spur. Heel Spurs form in some patients who have plantar fasciitis, and tend to occur in patients who have had the problem for a prolonged period of time. While about 70 % of
patients with plantar fasciitis have a heel spur, X-rays also show about 50 % of patients with no symptoms of plantar fasciitis also have a heel spur.
Because the diagnosis of heel spurs can be confused with tarsal tunnel syndrome (as described earlier), most surgeons advocate performing a tarsal tunnel release (or at least a partial tarsal tunnel
release) along with the plantar fascia release. This surgery is about 80percent successful in relieving pain in the small group of patients who do not improve with conservative treatments.
Non Surgical Treatment
FIRST, Reduce the acute pain. This is done by a combination of several things; injection of a synthetic relative of cortisone into the heel, a prescription of anti-inflammatory pills to reduce
inflammation, physical therapy and a special heel pad. About 50% of the time, these treatments will permanently relieve the pain. In the other 50%, the pain becomes recurrent, and the treatment
proceeds to Stage II. SECOND, Recurrent, painful heel spur is caused by the tug and pull of the plantar fascia ligament on the heel bone with each step. When the pain is recurrent, arch supports are
made to prevent sagging of the arch. The arch supports are custom-made according to the size and shape of the feet. This prevents the arch from sagging and the ligament from tugging and pulling on
the heel bone. The inflammation and pain eventually go away as the first phase of treatment is continued along with the arch supports, although the spur itself remains. THIRD, Surgery to remove the
spur is possible and is usually done as Day Surgery.
When chronic heel pain fails to respond to conservative treatment, surgical treatment may be necessary. Heel surgery can provide relief of pain and restore mobility. The type of procedure used is
based on examination and usually consists of releasing the excessive tightness of the plantar fascia, called a plantar fascia release. Depending on the presence of excess bony build up, the procedure
may or may not include removal of heel spurs. Similar to other surgical interventions, there are various modifications and surgical enhancements regarding surgery of the heel.