What is a Heel Spur?

A heel spur is medically caused when the heel bone extends past its normal boundaries and forms bony protrusions. Some heel spurs have protruded up to half an inch and have been seen on X-Ray. This is caused by the buildup of calcium deposits. It doesn’t happen all at once and often takes months to build up. If you do not have access to an X-Ray to diagnose your heel spur, your doctor will consider the symptoms and common causes.

They are most common among athletes and people who do a lot of running. They are typically caused by stretching of the plantar fascia or tearing of the heel bone membrane. This can also be caused by small fragments of bone breaking off one section of the foot, attaching onto the back of the foot.

In many cases, your condition is then called “heel spur syndrome”. Heel spurs are often associated with the extremely painful condition known as plantar fasciitis. This is the inflammation of the connective tissue that is situated across the bottom of the foot which serves to connect the ball of the foot and the heel bone.

What are the symptoms of a heel spur?

Patients can often have a heel spur without symptoms. When symptoms do occur, the most common ones are pain and swelling in the area around the heel, and difficulty with putting weight on the heel. The pain is usually felt on the inside on the heel and worsens when one is active.

Here are some home remedies that may be able to help with the pain:

1. Soaking your feet in an Epsom salt bath.
2. An apple cider vinegar bath.
3. Applying an ice pack to the affected area.

Foot Exercises to Help Relieve Heel Spur Pain or Reverse Spur Growth

One exercise has the ball of the foot against the wall while balance is maintained on the heel of the foot. The individual then shifts their weight towards the wall, causing a rubbing of the heel spur. Other exercises and stretches may also be performed that can help loosen and relax muscles and tendons in the feet, relieving pain.

Common Causes of Heel Spurs

In general, heel spurs occur when the foot ligaments and muscles are strained repetitively causing the membrane that covers the heel bone to be torn. This makes heel spurs especially common among athletes who regularly jump or run. However, heel spurs can also be caused by the following:

1. Gait issue, meaning when you walk, you place too much stress on the nerves, ligaments near the heel and the heel bone.
2. Poorly fitting or worn out shoes that do not provide enough support.
3. Being overweight
4. Arthritis
5. Heel bruise
6. Walking, jumping or running on hard surfaces, spending long periods of time on your feet daily for work.
7. High arches or flat feet
8. Having plantar fasciitis – all those who have heel spurs currently also have plantar fasciitis with these two conditions being closely associated.
9. Age – younger individuals also suffer from heel spurs but the pain associated with the condition usually intensifies in aging.

Risk Factors for Developing Heel Spurs

Having plantar fasciitis or any tendinopathy elsewhere in the body that has been present for over 8 weeks, places you at a higher risk of developing heel spurs as it demonstrates that there is excess tension and pulling at the tissues with the body trying to repair the condition. This places certain groups of people at a higher risk of heel spurs:

1. Those who wear high heeled shoes which adds more strain on the fascia and can shorten the Achilles tendon over time.
2. Older adults as over time, the flexibility of the plantar fascia decreases and the heel's protective fat pad that helps to cushion and protect the heel bone also thins.
3. Active runners, joggers and jumpers as more strain will be placed on the heel bone during training especially if training on hard surfaces and for many years.
4. Those with gait abnormalities which place excessive stress on the heel bone and the connecting tissues.
5. Those regularly wearing unsupportive or worn out shoes.

How can heel spurs be prevented?

Even if you have a genetic condition that affects the structure of your foot, it is possible to prevent heel spurs by taking appropriate steps. You may require orthotic insoles or adapted shoes to properly support your foot. Everyone can help to avoid heel spurs by wearing correctly-fitting shoes, and taking extra care to wear suitable footwear when playing sports. Maintaining a healthy weight is important when it comes to preventing heel spurs from occurring.

7 Conservative Heel Spur Treatment Options

1. Injection: An anti-inflammatory agent mixed with a numbing agent is placed at the painful area to alleviate the severe pain associated with the pain at night after a day of increased activity and with the first steps you take in the morning.
2. Stretching: Stationary stretching in the morning and evening utilizing the correct technique will speed recovery and diminish the chance of re-injury.
3. Rest: This can range from a reduction in activities to crutches and no weight bearing on the foot for 1 to 3 weeks. Don’t walk barefoot and avoid shoes that don’t have sufficient support.
4. Night Splints: This device maintains tension on the ligament while it’s healing by holding the foot at a 90-degree angle to the lower part of the leg.
5. Medication: Topical and oral anti-inflammatory medication can help relieve the discomfort that accompanies chronic heel spur pain.
6. Physical Therapy: Examples include cold therapy, stretching, ultrasound, electric stimulation, contrast baths, and massage.
7. Arch Support: Custom orthotics are the best solution for immediate and long-term treatment. But supportive athletic shoes, a higher heel on a shoe, or temporary arch supports will provide added rest to the injured ligament. 

When it’s time for surgery

If all else fails, your podiatrist may recommend surgery to remove the heel spur and, sometimes, release the plantar fascia muscle. The aim is to reduce pain and get you moving again without discomfort.

When to seek medical advice for Heel Spurs?

Heel spurs don’t occur overnight. In addition, most painful heel spurs only occur because minor symptoms were ignored and treatment was not sought. In general, if you have had heel pain that has persisted regularly for over a month, it’s a good idea to see a podiatrist. You may contact us today for further assessment and evaluation. You may reach us in Bethesda, Maryland to schedule an appointment. 

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