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Monday, August 18, 2014

What is a Heel Spur?

Heel Spurs are bone spurs which form on our heel bone called "calcaneus".

What causes Heel Spurs?

Many other structures in our foot and ankle attach to our heel bone (muscle tendons, ligaments, fascia). Heel spurs usually form at these attachment points due to chronic inflammation from overuse. This inflammation eventually causes a bone spur to form. A common reason for heel spurs is "plantar fasciitis". The plantar fascia is tissue on the bottom of our foot which runs from the heel bone all the way to the balls of our foot.  When this tissue become inflamed (plantar fasciitis), it can cause heel spurs where it attaches to the heel bone.

Who has a higher risk to develop Heel Spurs?

Several conditions can make it more likely for you to develop heel spurs:

1. Abnormal Gait
2. Running and jogging on hard surfaces
3. Being overweight or obese
4. Wearing shoes without a good arch support.

What Symptoms do Heel Spurs cause?

Most patients experience pain and tenderness with walking, or just putting pressure on the heel. The pain is often described as a sharp "knife" or "needle" like sensation in the heel when first getting out of bed. Later in the day, the pain become more of a dull ache. The pain often gets worse with jogging or running. Walking barefoot on a hard surface can also be uncomfortable. Some patients can feel pain in other areas of the foot as well. This is due to inflammation which spreads from the heel to elsewhere in the foot.



How are Heel Spurs diagnosed?

A patient history of having pain and tenderness in the heel is often very suggestive of a heel spur. As the doctor pushed on the heel, you may feel your typical pain. An X-Ray will show bone spurs once they reach a certain size.

Here is a Color X-Ray which shows a typical heel spur. This Image is Interactive. Just move your Mouse Cursor over the Image and see the Image Tags come alive. Each tag displays text to explain a specific structure (if the Interactive Tags do not display properly due to slow Browser Speed, just refresh the page).



Lateral Color X-Ray of a Heel Spur
Interactive Color X-Ray of a Heel Spur

How are Heel Spurs treated?

The treatment of heel spurs depends on the severity of the pain and how much it impacts on your life. Here are some of the common treatments:

1. Anti-Inflammatory Medications (Ibuprofen, Naproxen Sodium, etc.)
2. Shoe inserts which are soft, donut shaped
3. Physical Therapy (PT) techniques to stretch the plantar fascia and foot tendons
4. Ice
5. Steroid Injections to calm the inflammation, followed by PT
6 Surgery: This is rarely done. Removing the spur itself may not give you pain relief.


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