A heel spur is a bone growth at the bottom of the foot, the place where the plantar fascia is inserted. In a radiograph it has the appearance of a prominent bone.
The spur is the most frequent pathological condition that involves the heel. Because of the area of pain, it may cause some controversy in discussions in the medical world since it can easily be confused with plantar fasciatis and vice versa.
Today we know that:
1)the heel spur appears in a percentage of 13 – 27% of humanity(one person in five have a heel spur) without it being constantly painful
2)in many cases, the spur may be present in both feet while only one heel is painful
3)people suffering from heel pain, are much more likely to have heel spurs and
4)the treatment of plantar fasciatis does not appear to have a connection with the appearance or disappearance of a heel spur
These are some of the reasons where the term “heel spur” is considered old fashioned as a term of diagnosis and it gradually disappears, since it is not clear that is the cause of heel pain.
The most frequent causes of plantar fasciatis are:
1)very tight calf muscles
2)standing and excessive pressure while walking, at work with considerable weight bearing and shoes that do not adequately support the arch of the foot
3)a very high or very low foot arch and overpronation of the foot
5)women are more prone to develop plantar fasciatis than men
6)age matters usually above 30s, especially between 40 and 60 years
7)injury and diabetes
Plantar fasciatis and the presence of a heel spur are very common in athletes, long distance runners and dancers. Obese patients, women at the period of pregnancy and those that wear worn shoes with inadequate arch support are at great risk of suffering from plantar fasciatis in the future.
How can plantar fasciatis be cured?
Plantar fasciatis may disappear without treatment since it can be categorized as a self – limited condition. This can last for months but there is a high probability of recurrence.
That is why plantar fasciatis requires a series of treatment options:
- Reduction in physical activity: Stop exercising for a few weeks and avoid standing for a long time or walk on harsh surfaces for a long time
- Stretching: A special plantar fascia stretching program under the supervision of a specialist. Those programs will substantially reduce pain and initialize the relaxing mechanisms of the muscles involved and will reduce pain if the condition reappears
- Casts and taping: Those will hold the plantar fascia stretched during the night
- Icing and anti-inflammatory medication: Use a full, frozen water bottle or a can, to apply pressure at the arch of the foot and roll it starting from the heel and end at the end of the metatarsal heads(refer to the exercises above)
Custom insoles: The custom insoles with significantly reduce the forces that are applied on the plantar aspect of the foot and realign the axons so that the foot is working properly
In cases where the above do not work, surgery can correct the problem. The selection of patients must be extremely meticulous and surgery is never the first course of action.