There are approximately 75 different causes of heel pain. At least 80% of all heel pain is due to heel spurs. A heel spur contains calcium, but cannot truly be called a calcium deposit. Bone spurs,
whether they are on the heel or on any other bone of the body, are true bone -- they are true enlargements of the bone and may be sharp and pointed, or round and knobby. Since bone spurs are true
bone, they contain calcium just like regular bones, but are not pure calcium deposits.
Causes of Heel Spur Syndrome are mostly due to your foot structure. Foot structure is due to hereditary for the most part, meaning it was the way you were when born. Other factors such as increase in
weight, injury, improper shoes, or different activities may change the way your foot functions as well. If one leg is longer or shorter than the other, this may make your foot function improperly and
be the cause of the heel spur syndrome. Improper shoes may be ones that are new or ones that are worn out and do not give good support. The higher priced shoes do not mean it's a better shoe.
Pronation is a term used to describe a foot which allows the arch to fall more than normal and allows for the fascia along the bottom of the foot to put a tighter pull or a different angle of pull on
the heel bone. Over time, this constant pull of the tight fascia can force the bone to enlarge and form a spur. It is not the heel spur that causes the pain directly. The spur may cause pressure
against a nearby nerve causing a neuritis, or a bursa causing a bursitis.
With heel spurs, people often talk about a dull ache which is felt most of the time with episodes of a sharp pain in the center of the heel or on the inside margin of the heel. Often the pain is
worse on first rising in the morning and after rest and is aggravated by prolonged weight bearing and thin-soled shoes.
Your doctor will discuss your medical history and will examine your foot and heel for any deformities and inflammation (swelling, redness, heat, pain). He/she will analyze your flexibility,
stability, and gait (the way you walk). Occasionally an x-ray or blood tests (to rule out diseases or infections) may be requested.
Non Surgical Treatment
To aid in the reduction of inflammation, applying ice for 10-15 minutes after activities and the use of anti-inflammatory medications, such as aspirin or ibuprofen, can be helpful. Corticosteroid
injections may also be used to reduce pain and inflammation. Physical therapy can be beneficial with the use of heat modalities, such as ultrasound, that create a deep heat and reduce inflammation.
If the pain caused by inflammation is constant, keeping the foot raised above the heart and/or compressed by wrapping with a bandage will help. Taping can help speed the healing process by protecting
the fascia from reinjury, especially during stretching and walking.
Sometimes bone spurs can be surgically removed or an operation to loosen the fascia, called a plantar fascia release can be performed. This surgery is about 80 percent effective in the small group of
individuals who do not have relief with conservative treatment, but symptoms may return if preventative measures (wearing proper footwear, shoe inserts, stretching, etc) are not maintained.