Heel spurs are a relatively common cause of heel pain. A heel spur is a pointed bone fragment that extends forward from the bottom of the heel from the heel bone, also referred to as a calcaneous.
Serious pain and discomfort often develops with this condition. In many cases, a heel spur develops along with plantar fasciitis which occurs when the plantar fascia ligament becomes inflamed.
A major cause of heel spur pain comes from the development of new fibrous tissue around the bony spur, which acts as a cushion over the area of stress. As this tissue grows, a callus forms and takes
up even more space than the heel spur, leading to less space for the thick surrounding network of tendons, nerves, ligaments and supporting tissue. These important structures in the foot have limited
space because of calcium or tissue buildup, which leads to swelling and redness of the foot, and a deep throbbing pain worsened with exercise.
The pain caused by a calcaneal spur is not the result of the pressure of weight on the point of the spur, but results from inflammation around the tendons where they attach to the heel bone. You
might expect the pain to increase as you walk on the spur, but actually it decreases. The pain is most severe when you start to walk after a rest. The nerves and capillaries adapt themselves to the
situation as you walk. When you rest, the nerves and capillaries rest, also. Then, as you begin to move about again, extreme demands are made on the blood vessels and nerves, which will cause pain
until they again adjust to the spur. If excessive strain has been placed on the foot the day before, the pain may also be greater. A sudden strain, as might be produced by leaping or jumping, can
also increase the pain. The pain might be localized at first, but continued walking and standing will soon cause the entire heel to become tender and painful.
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
Heel pain may be associated with a heel spur, however the heel pain is usually due to plantar fasciitis, rather than a heel spur, so treatment is usually directed at the plantar fasciitis itself.
Treatment usually involves application of ice to reduce pain and inflammation, special stretching exercises, and pain-relieving or anti-inflammatory medicines. Night splints or orthotics may be
recommended. It may help to avoid the activities that aggravate pain, such as long walks and running. Surgery is very rarely recommended and only after other measures fail.
Have surgery if no other treatments work. Before performing surgery, doctors usually give home treatments and improved footwear about a year to work. When nothing else eases the pain, here's what you
need to know about surgical options. Instep plantar fasciotomy. Doctors remove part of the plantar fascia to ease pressure on the nerves in your foot. Endoscopy. This surgery performs the same
function as an instep plantar fasciotomy but uses smaller incisions so that you'll heal faster. However, endoscopy has a higher rate of nerve damage, so consider this before you opt for this option.
Be prepared to wear a below-the-knee walking cast to ease the pain of surgery and to speed the healing process. These casts, or "boots," usually work better than crutches to speed up your recovery
Choose new shoes that are the right size. Have your foot measured when you go to the shoe store instead of taking a guess about the size. Also, try on shoes at the end of the day or after a workout,
when your feet are at their largest. To ensure a good fit, wear the same type of socks or nylons that you would normally wear with the type of shoe that you are trying on.