What is it?
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 the same.
Symptoms may be similar to those of plantar fasciitis and include pain and tenderness at the base of the heel, pain on weight bearing and in severe cases difficulty walking. The main diagnosis of a heel spur is made by X-ray where a bony growth on the heel can be seen.
A heel spur can occur without any symptoms at all and the athlete would never know they have the bony growth on the heel. Likewise, Plantar fasciitis can occur without the bone growth present.
Common causes of this bone spur in the heel are repetitive trauma to the base of the heel, obesity, poor walking/running technique, poorly fitting shoes, or hereditary conditions.
The most important part of treatment is to rest. Do not undertake activities which hurt the foot or aggravate symptoms as will only cause painful symptoms to persist.
Apply an ice pack regularly for 10 minutes at a time every hour initially to reduce pain and inflammation of the surrounding tissues. As symptoms subside frequency of application can reduce to 2 or 3 times per day. Exercises and stretches to keep the foot and ankle strong and mobile are important as long as pain allows. Stretching the plantar fascia is important, especially if symptoms are worse in the morning. A plantar fasciitis night splint is excellent for stretching and preventing the plantar fascia tightening up over night.
Anti-Inflammatory medicine (e.g. ibuprofen) may be prescribed.
Shoe inserts can help to take the pressure off of the spur and reduce pain. If these treatments do not significantly ease the symptoms then surgery may be an option.
Plantar fasciitis can be treated with surgery when non-operative measures do not resolve the symptoms. Most surgeons require that patients fail at least 9 months of conservative treatments (such as injections, physical therapy, arch supports, etc) before surgery. There are two aspects of plantar fasciitis syndrome that are important when considering plantar fasciitis surgery:
1) the “tight” plantar fascia ligament, and
2) the presence of a heel (bone) spur.
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