Foot pain is something most people are familiar with. Everyone’s experienced a throbbing, stabbing, or tingling pain in the foot at one time or another. If you’re experiencing recurrent foot pain in the same circumstances over and over, it may be a sign of a heel spur. Learn more about this common condition below.
What Is A Heel Spur?
A heel spur is an abnormal bone growth that occurs on the calcaneus, the heel bone at the rear of the foot. Like bone spurs in other parts of the body, heel spurs typically form in response to joint or ligament damage. Heel spurs, which are formally called calcaneal spurs by medical professionals, can appear on either the underside or the rear of the heel.
Posterior heel spurs – those that show up at the rear or the heel – are usually associated with damage caused to the Achilles tendon. This tendon runs all the way up the leg, and it’s anchored to the heel bone at its lower end. Posterior spurs do not often cause pain, and very few people need medical intervention to help with them.
Interior heel spurs are a different story. These spurs relate to the plantar fascia, the thick ligament running along the bottom of the foot. The body may form interior heel spurs in response to damage of the plantar fascia over time. Heel spurs form slowly as small amounts of extra calcium are deposited on the face of the heel bone repeatedly.
Heel spurs can grow very large with or without causing significant pain. Interior spurs may be up to a half-inch in length. Posterior spurs can grow large enough to be palpable or even visible under the skin of the heel.
Heel spurs themselves do not pose any significant threat to your health. They can cause damage to the soft tissues around them, though, and the pain caused by this damage may be debilitating and chronic. In cases such as these, a range of different treatments can be used to resolve the problem.
What Are The Symptoms Of Heel Spurs?
The key symptom of the presence of a heel spur is heel pain. Spurs are not the only condition that can cause pain in this region, and not all spurs cause pain. However, the presence of a heel spur is closely associated with heel pain that shows up in certain specific conditions.
Sharp, stabbing pain in one or both heels that makes itself felt as soon as you wake up and start walking is the classic symptom of heel spurs. For some people, continuing to walk will bring relief and cause no further problems. Other people who have heel spurs find that continued walking or other forms of strain can bring the pain back or make it worse.
As noted above, posterior heel spurs may be easy to see and feel right through the skin. This is rarely the case with interior heel spurs, though. Because they are densely covered by soft tissue it is very rare to be able to feel their presence through the foot. The existence of an interior heel spur will make itself felt via stabbing pain.
Because heel spurs are effectively permanent, the pain that they cause tends to be chronic, i.e. long-lasting. Heel pain that comes back repeatedly in the same circumstances for six months or longer is usually a strong indicator that heel spurs may be present.
Some patients experience heel spur pain in both feet at the same time, while others experience it in only one foot. The treatments outlined below can be applied to either one or both feet depending on the patient’s needs.
What Causes Heel Spurs?
Despite the fact that the heel spur is a very common condition that has been known for centuries, the exact causes that lead to heel spurs are still poorly understood. The best theories put forth today suggest that a heel spur is a natural response of the body to damage of the Achilles tendon or the plantar fascia.
These soft tissues are vital for the proper movement of the feet and legs. Their connection to the heel bone gives them the support they need to do their jobs. The human body may well react to tissue / ligament damage close to the heel by attempting to provide additional skeletal support.
Most heel spurs are created over a lengthy course of time as additional calcium is deposited on the surface of the calcaneus in minute quantities. That means repeated or chronic soft tissue injuries are required to cause heel spurs to grow very large.
Heel spurs are associated with repetitive stress injuries where the heels are subjected to undue stress repeatedly or for long periods of time. Examples of conditions which are known to encourage heel spur formation include obesity (adding weight to the heel), work or life habits that involve extended periods of standing, walking, or running, and footwear that fits poorly and/or subjects the heel to excessive stress.
Heel spurs start to cause pain and become an issue when they get large enough to damage or inflame the very tissues they’re meant to support. Rubbing up against a heel spur or getting pinched or trapped by it can damage the Achilles tendon and especially the plantar fascia.
How Are Heel Spurs Related To Plantar Fasciitis?
Heel spurs and plantar fasciitis often strike the same individuals. Irritatingly, this is another place where medical science has failed to fully explore the relationship between two conditions that are known to affect each other. It still hasn’t been established with any certainty whether plantar fasciitis causes heel spurs or heel spurs cause plantar fasciitis.
The good news is that the non-invasive treatments for the two conditions are largely the same, so most patients can treat the issues simultaneously. As long as the steps taken are effective at relieving your pain, you need not worry unduly about the underlying cause.
In cases where the severity of the condition requires surgery, let your doctor determine the full range of treatments required. A single operation is frequently used to both remove heel spurs and treat the plantar fascia, and the specific steps taken will depend on the information your doctor gathers about your condition prior to surgery.
How Are Heel Spurs Diagnosed?
As per the information above, chronic heel pain that stretches over six months or more is a strong sign that a heel spur may be present. It’s an excellent idea to consult with a doctor if you experience long-term heel pain.
A doctor will ask you a series of questions regarding your lifestyle and your daily activities to find out more about your heel pain. Common risk factors like those described above (obesity, long periods of standing, etc.) will be assessed. This is all part of the process of differential diagnosis, intended to zero in on the underlying cause of your foot pain.
While an experienced physician or a specialist like a podiatrist may be able to diagnose a heel spur simply by gathering information and examining your feet, a foot x-ray is required to know for certain whether or not a heel spur is present. The vast majority of pain-causing heel spurs are quite easy to spot on a properly processed foot x-ray.
X-rays will always be used to diagnose chronic heel pain before any invasive treatment (like surgery) is planned. This makes certain that the underlying cause of the problem – whether it’s a heel spur or something else – gets addressed.
How To Cure Heel Spurs?
A heel spur is one of those medical conditions where it’s important to distinguish between treatment and cure. For many patients, when the condition is diagnosed and treatment begins relatively early, non-invasive techniques are completely effective at relieving heel spur pain and keeping it from coming back. When heel spurs are left untreated, the corrective measures required to resolve the problem and get rid of the pain can become expensive, complex, and even risky.
Minor treatments for heel spurs include getting off your feet and resting, icing the affected area, taping the heel up, and undergoing certain types of physical therapy. Painkillers can be used to treat the pain heel spurs cause. These are all typically treatments that are suitable for minor, non-chronic cases.
More long-term solutions include using orthotics – custom-designed foot appliances – to correct problems in your gait that lead to heel spur pain. Changing your working and exercising habits to reduce the amount of stress you put on the area can also help. Wearing more supportive shoes which fit properly is also helpful.
In the most extreme cases, surgery is required to remove heel spurs. Only a few patients end up going this far to relieve heel spur pain, and the vast majority of people can successfully treat their symptoms without resorting to surgery. Surgery for heel spurs is often combined with surgery for plantar fasciitis in cases where the two conditions are connected.
Heel spur surgery can be performed either traditionally or endoscopically, using miniaturized tools inserted through very small incisions. Endoscopic surgery offers a shorter healing process, but it may not be suitable for all cases.
When Is Heel Spur Surgery Recommended?
Surgery is considered the most extreme treatment for heel spurs, and it’s generally prescribed for only about five percent of the people who have spurs. Your doctor will probably only suggest surgery if other less-invasive treatment options have already proven to be unsuccessful. Doctors are generally hesitant to move to surgical options because many of the potential side effects involved can be as disruptive as heel spurs themselves
Patients who are good candidates for heel spur surgery are those who have suffered from recurring pain for more than six months and find it difficult to work or live the way they want to due to the pain the spurs cause. In very rare circumstances, heel spur surgery may become a more pressing need. This is usually only the case for athletes who find it impossible to maintain their training and performance regimen due to the spurs.
How Long Does It Take To Recover From Heel Spur Surgery?
Recovery times for heel spur surgery will depend on exactly what surgical measures were taken and how your surgeon operated. An endoscopic procedure that uses only limited incisions will heal rapidly. Patients who get this type of surgery can begin wearing regular shoes and walking normally in just a few days. Full recovery is generally complete within a month.
Traditional “open” surgery will usually require you to keep weight off your heel for an extended period after the procedure. This is accomplished by putting your foot in a cast or having you wear a CAM boot or other form of brace. You’ll generally need this additional support for two to three weeks, with full healing requiring another three weeks after that.
Your doctor will give you extensive aftercare instructions following heel spur surgery. These must be followed precisely to encourage proper healing and prevent potentially dangerous side effects like infection or nerve damage. Do not rush the healing process after foot surgery. Unintended surgical effects can become as much of a problem as heel spurs themselves.
How To Prevent Heel Spurs?
Some of the treatment methods above can be helpful in slowing the growth of heel spurs and keeping them from causing pain in the future. This is particularly true of wearing orthotics and changing the types of shoes you wear.
There is a range of different activities that have been linked to heel spur formation. By avoiding these activities or minimizing the amount of time you spend doing them you can slow down or even prevent the formation of heel spurs. In most cases, it is the combination of inadequate heel support from your footwear and stressful repetitive motions that encourage spur growth. This is why you should take extra care to wear shoes which give you adequate support and fit properly. Replace your shoes regularly as they become worn and start to provide less heel support.
Walking long distances is a common habit associated with heel spurs, so the condition is frequently seen in golfers. Running on hard pavement is also linked to heel spur formation. If you engage in this type of athletic activity, proper supportive footwear is absolutely vital.
Losing weight can help prevent heel spur formation by minimizing the amount of stress your tendons and ligaments are subjected to from body weight. You should also alter your working habits if your job requires you to stand for extended periods of time. Take breaks to relieve the stress on your heels.
Although heel spurs can be very painful, they don’t pose an urgent threat to your health. The sooner you seek treatment for them the easier it will be to resolve the pain they cause, though. That means it’s always in your best interest to consult with your doctor about recurrent heel pain sooner rather than later.