Heel spurs are small lumps of excess bone that grow and stick out on the calcaneus, aka heel bone. They usually develop in response to friction, tightness, inflammation or injury when the body lays
down extra layers of bone to try and protect itself. There are two areas where heel bone spurs tend to develop. At the back of the heel: these are usually due to conditions such as Achilles
tendonitis, tight calf muscles or wearing tight footwear. These are known as posterior calcaneal spurs. Underneath the heel: these are usually due to conditions such as plantar fasciitis, muscle
imbalance or altered foot biomechanics. These are known as inferior calcaneal spurs.
This condition is a constellation of many causes; overweight, ill fitting shoes, bio-mechanical problems (mal-alignment of the heel), gout, pronation (a complex motion including outward rotation of
the heel and inward rotation of the ankle) and rheumatoid arthritis are some of the causes of heel pain.
Pain and discomfort associated with heel spurs does not occur from the spur itself. The bone growth itself has no feeling. However, as you move, this growth digs into sensitive nerves and tissue
along the heel of the foot, resulting in severe pain. Pain can also be generated when pushing off with the toes while walking. Swelling along the heel is also common.
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
Acupuncture and acupressure can used to address the pain of heel spurs, in addition to using friction massage to help break up scar tissue and delay the onset of bony formations. Physical therapy may
help relieve pain and improve movement. The Feldenkrais method could be especially helpful for retraining some of the compensation movements caused by the pain from the spur. Guided imagery or a
light massage on the foot may help to relieve some of the pain. Other treatments include low-gear cycling, and pool running. Some chiropractors approve of moderate use of aspirin or ibuprofen, or
other appropriate anti-inflammatory drugs. Chiropractic manipulation is not recommended, although chiropractors may offer custom-fitted shoe orthotics and other allopathic-type treatments.
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