A heel spur is a hooked bony growth protruding from the calcaneus or heel bone. It often occurs alongside plantar fasciitis, and as such the two conditions are often confused, however they are not
Heel spurs develop as an abnormal growth in the heel bone due to calcium deposits that form when the plantar fascia pulls away from the heel. This stretching of the plantar fascia is usually the
result of over-pronation (flat feet), but people with unusually high arches (pes cavus) can also develop heel spurs. Women have a significantly higher incidence of heel spurs due to the types of
footwear often worn on a regular basis.
Heel spur is characterised by a sharp pain under the heel when getting out of bed in the morning or getting up after sitting for a period of time. Walking around for a while often helps reduce the
pain, turning it into a dull ache. However, sports, running or walking long distance makes the condition worse. In some cases swelling around the heel maybe present.
The diagnosis of heel pain and heel spurs is made by a through history of the course of the condition and by physical exam. Weight bearing x-rays are useful in determining if a heel spur is present
and to rule out rare causes of heel pain such as a stress fracture of the heel bone, the presence of bone tumors or evidence of soft tissue damage caused by certain connective tissue disorders.
Non Surgical Treatment
Treatments for bone spurs and plantar fasciitis include Stretching the calf muscles several times daily is critical in providing tension relief for the plantar fascia. Some physicians may recommend
using a step to stretch, while others may encourage yoga or pushing against a wall to stretch. Icing after activity. A frozen tennis ball can provide specific relief. Rolling the tennis ball under
the arch of the foot after exercise can lessen pain in the area. Taping is also recommended at times. Several manufacturers of sports tape have plantar fascia specific lines. Orthotics are a good
idea for those on their feet during the day. Orthotics can provide cushioning and relief. Cortisone shots in the fascia can provide temporary anti-inflammatory relief. Losing weight is perhaps the
most effective method of improving heel and foot pain. Those who are overweight are far more likely to report these syndromes.
Approximately 2% of people with painful heel spurs need surgery, meaning that 98 out of 100 people do well with the non-surgical treatments previously described. However, these treatments can
sometimes be rather long and drawn out, and may become considerably expensive. Surgery should be considered when conservative treatment is unable to control and prevent the pain. If the pain goes
away for a while, and continues to come back off and on, despite conservative treatments, surgery should be considered. If the pain really never goes away, but reaches a plateau, beyond which it does
not improve despite conservative treatments, surgery should be considered. If the pain requires three or more injections of "cortisone" into the heel within a twelve month period, surgery should be
In 2002, researchers attempted to compare the effects of various running techniques on pronation and resulting injuries like stress fractures and heel spurs. They suggested that it is possible to
teach runners to stride in such a way as to minimize impact forces. One way is to lower running speed. Another is to take longer rest periods following a run.