Heel Spur

Autor: RAFAŁ CZEPUŁKOWSKI
Consultation PAWEŁ BĄKOWSKI
Date added 11.12.2024
Date of last revision 11.12.2024

Table of contents:

A heel spur is an extra bony tissue visible on an X-ray as a bony projection or spur on the calcaneus (heel bone). This characteristic sharp bony outgrowth, extending from the heel tuberosity towards the front of the foot, results from prolonged inflammation of the plantar fascia. A heel spur can cause significant pain in the medial region of the calcaneus.

Table of contents:

Causes of a Heel Spur

A heel spur develops as a bony protrusion on the calcaneus. It often manifests as sudden and severe heel pain. The formation process of a heel spur typically spans several months and is caused by strain on the muscles and ligaments of the foot, chronic inflammation of the plantar fascia, and repeated tears of the membrane covering the heel bone.

Heel spurs can affect both men and women. Obese individuals and those with limited ankle mobility are particularly at risk. Heel spurs may result from prolonged wearing of high-heeled shoes in women or be associated with athletic activities, such as running or dancing.

Risk Factors for Heel Spurs

  • Abnormal gait causing excessive pressure on the heel bone
  • Running on hard surfaces
  • Improper footwear, particularly with poorly fitted arch support
  • Spending most of the day on one’s feet
  • Overweight and obesity
  • Diabetes
  • Reduced elasticity of the plantar fascia with age

Is a Heel Spur the Same as Plantar Fasciitis?

Heel spurs and plantar fasciitis are related conditions but not identical. Plantar fasciitis involves inflammation of the fascia that extends between the heel and the sole of the foot. The inflammation causes intense, stabbing heel pain that may come and go throughout the day. Heel spurs, on the other hand, typically occur as a reaction to chronic plantar fascia inflammation, eventually leading to the formation of additional bony tissue in the form of a spur. Most people do not experience pain directly from a heel spur.

How to Treat a Heel Spur?

Heel spurs can manifest in two forms: plantar fasciitis and its degenerative form. Accurate diagnosis is critical for further treatment. In mild cases, proper footwear, cushioning insoles to reduce heel bone pressure, and stretching exercises are usually sufficient. Advanced cases may require pharmacotherapy, including nonsteroidal anti-inflammatory drugs (NSAIDs) or steroid injections, alongside rehabilitation.

Heel Spur - Degenerative Changes

When cells in the plantar fascia die and are replaced by degenerative myxoid changes, the healing and regenerative potential of the tendon becomes highly limited. In such cases, treatments involving stem cells are used. Bone marrow from the patient is commonly harvested, prepared, and injected under ultrasound guidance into the most damaged areas of the plantar fascia. These medications serve as a supplement to the main treatment—rehabilitation. Plantar fasciitis rarely occurs in isolation and is often accompanied by calf muscle contractures or foot structure abnormalities. Comprehensive treatment of these accompanying conditions is crucial, and accurate diagnosis is essential.

When Is Surgery for a Heel Spur Necessary?

In severe and advanced cases of heel spurs, where non-surgical treatments have failed, surgical intervention may be required. At our clinic, we perform endoscopic treatment of plantar fasciitis, which helps restore functionality and provides long-term positive outcomes.

Heel spur surgery is indicated when non-surgical treatments fail to yield the desired results. It is typically performed endoscopically, using minimally invasive techniques. Two small skin incisions allow the insertion of appropriate tools, along with a camera and visualization system, to perform all necessary procedures. Heel spur surgery often involves excising inflamed or scarred tissue and partially incising the plantar fascia. The procedure avoids major disruption to foot structures, including joints, ligaments, and blood vessels, resulting in a low risk of complications. The small incisions enable a quick recovery. No plaster immobilization is used post-surgery. Instead, patients are instructed on exercises to restore foot function to its original state. Patients can leave the hospital the day after surgery. For two weeks, crutches are recommended to minimize discomfort.

Exercises for Heel Spurs

To reduce the risk of heel spurs, adhere to simple guidelines, such as wearing proper footwear, warming up before physical activity, and using compression bands with alternating zones of compression. Stretching and rolling exercises are critical elements of both prevention and treatment and are detailed in a separate article.

Exercises for heel spurs:

Plantar Fascia Exercises - Specific exercises focus on strengthening and stretching the plantar fascia to alleviate pain and prevent recurrence.

Related Articles:

Learn about other possible foot and ankle injuries.

Bibliography:

Autor
RAFAŁ CZEPUŁKOWSKI
RAFAŁ CZEPUŁKOWSKI

Specjalista do spraw content marketingu, dziennikarz sportowy i medyczny. Redaktor naczelny magazynu „Poradnik Zdrowie i Sport”, członek Dziennikarskiego Klubu Promocji Zdrowia, współtwórca wielu artykułów medycznych z zakresu ortopedii i urazowości w sporcie.

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Konsultacja merytoryczna
PAWEŁ BĄKOWSKI
PAWEŁ BĄKOWSKI

Lekarz w klinice Rehasport, specjalista w leczeniu chorób i uszkodzeń kończyny dolnej. Zainteresowania ortopedy koncentrują się wokół zabiegów artroskopowych, urazów sportowych, jak również traumatologii dziecięcej.

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