Overview
A common cause of heel pain is the heel spur, a bony growth on the underside of the heel bone. The spur, visible by X-ray, appears as a protrusion that can extend forward as much as half an inch. When there is no indication of bone enlargement, the condition is sometimes referred to as “heel spur syndrome.” Heel spurs result from strain on the muscles and ligaments of the foot, by stretching of the long band of tissue that connects the heel and the ball of the foot, and by repeated tearing away of the lining or membrane that covers the heel bone. These conditions may result from biomechanical imbalance, running or jogging, improperly fitted or excessively worn shoes, or obesity.
Causes
Heel spurs are bony outgrowths positioned where the plantar fascia tissue attaches to the heel bone (the calcaneus). Heel spurs seldom cause pain. It is the inflamed tissue surrounding the spur that causes the pain. The Latin meaning of Plantar Fasciitis is, ?Inflammation of Plantar Fascia.? The plantar fascia is a long, thick and very tough band of tissue beneath your foot that provides arch support. It also connects your toes to your heel bone. Each time you take a step, the arch slightly flattens to absorb impact. This band of tissue is normally quite strong and flexible but unfortunately, circumstances such as undue stress, being overweight, getting older or having irregularities in your foot dynamics can lead to unnatural stretching and micro-tearing of the plantar fascia. This causes pain and swelling at the location where the plantar fascia attaches to the heel bone. As the fascia continually pulls at the heel bone, the constant irritation eventually creates a bony growth on the heel. This is called a heel spur.
Symptoms
Some symptoms at the beginning of this condition include pain and swelling, and discomfort when pushing off with the toes during walking. This movement of the foot stretches the fascia that is already irritated and inflamed. If this condition is not treated, pain will be noticed in the heel when a heel spur develops in response to the stress. This is a common condition among athletes and others who run and jump a significant amount.
Diagnosis
A heel spur is often seen on X-ray as a bony protrusion, which can vary in size. However, because a Heel Spur only indicates increased load on the plantar fascia, and not pain, an ultra sound may be required to assess other actual cause of the heel pain such and may include checking to see if the plantar fascia is inflamed or degenerated.
Non Surgical Treatment
In case of heel spurs rest is most important. Active sports, running, long walks etc should be avoided to start with. If you?re in a job that requires a lot of standing, take a few days off work. Rest (or reduced activity) is essential to allow the inflammation from becoming aggrevated. Furthermore, you can use ice packs (placed on the heel for 5-10 minutes) to ?cool down? the inflamed area. You may take anti-inflammatory medication or apply a topical inflammatory (i.e. a cream) to help reduce inflammation. In addition, there are some simple exercises that should be done daily to help relieve heel spur pain.
Surgical Treatment
In a small number of cases (usually less than 5 percent), patients may not experience relief after trying the recommendations listed above. It is important that conservative treatments (such as those listed above) be performed for AT LEAST a year before considering surgery. Time is important in curing the pain from heel spurs, and insufficient treatment before surgery may subject you to potential complications from the procedure. If these treatments fail, your doctor may consider an operation to loosen the plantar fascia, called a plantar fascia release.
Prevention
Walk around before you buy shoes. Before you purchase your shoes, do the following. Re-lace the shoes if you’re trying on athletic shoes. Start at the farthest eyelets and apply even pressure to the laces as you come closer to the tongue of the shoe. Make sure that you can wiggle your toes freely inside of the shoe. Also, make sure that you have at enough space between your tallest toe and the end of the shoe. You should have room equal to about the width of your thumb in the tip of your shoe. Walk around to make sure that the shoe has a firm grip on your heel without sliding up and down. Walk or run a few steps to make sure your shoes are comfortable. Shoes that fit properly require no break-in period.