(Also Known as Calcaneal Spurs or Osteophytes)
When the body is under stress or constant inflammation it will deposit calcium to our bones. This added 'bone growth' is designed to relieve the added stress/pressure to our connective tissue.
In the case of a heel spur, the body adds calcium to the heel bone; typically, this calcium is added to the bottom underside of the heel bone where the plantar fascia attaches. This calcium deposit forms over a period of many months.
Heel bones vary in shape and size from person to person and an irregular shaped heel (calcaneus heel) can often cause the Plantar ligament or Achilles tendon to twist. Also, the smaller the heel bone, the greater the stress put on tendons and ligaments (as they are attached at smaller points.
Extra tension can result in overstretching, inflammation and/or micro-tearing of the plantar fascia, strains on the foot muscles and ligaments, and repeated tearing of the membrane that covers the heel bone. As your body tries to heal itself, the heel spur forms from calcium deposits (osteophytes) at the bottom of your heel. It can vary in shape from a flat, shelf-like growth to a hook-shaped, pointy projection, and can extend forward up to a half inch. Your body hopes this extra bone and tissue will help to relieve the pressure on your plantar fascia.
The spur itself is not painful, however, if it is sharp and pointed it can poke into soft tissue surrounding the spur itself. As the bone spur irritates the tissue, inflammation and bruising can occur leading to heel pain.
Heel spurs can affect your ability to do your usual work and/or activities, and can also trap and irritate the nerves in your heel area. They can change the way you walk, and can lead to knee, hip and low back injuries. If severe, they may require medical intervention.
Who can be affected by heel spurs? 10-21% of the population, mostly often seen in athletes, people who are on their feet all day, are overweight, and/or over 40 years of age.
Many people refer to plantar fasciitis and heel spurs as one in the same. Although these are similar, they are not same. Heel spurs can actually be caused by plantar fasciitis; 50% of people with plantar fasciitis have heel spurs, whereas 19% of people have heel spurs without plantar fasciitis.
Alternate names and/or associated conditions: Pump bump, exostosis, calcaneal spur syndrome, heel spur syndrome, Haglund's deformity
There is no single cause for Heel Spurs, though as mentioned previously, heel spurs will often occur in someone suffering from plantar fasciitis (50% of Plantar Fasciitis suffers have heel spurs). To a significant degree, you can assume that some causes of Heel Spurs (HS) are also causes of Plantar Fasciitis (PF). There is also a strong correlation between HS/PF and underlying diseases that cause arthritis (inflammation of the joints) such as Ankylosing Spondylitis (a form of arthritis featuring chronic inflammation of the spine and sacroiliac joints) and Reactive Arthritis (inflammation of the joints due to an infection in another part of the body).
Faulty Foot Structure
Faulty foot structures are known to cause heel spurs. Most common faulty structures are:
- Differing Leg Lengths
Differing leg lengths affect the way you walk (gait); often the change in gait will result in excessive, repetitive force in the foot, knee and/or hips. Too much pressure on the heel or ball of the foot results in plantar fasciitis, heel spurs or other foot-related soft tissue injuries.
- Unhealed Injuries (ie. foot tendinitis, plantar fasciitis)
- Flat Feet (Overpronation of the Foot)
Flat feet can be hereditary or develop later on due to various reasons that involve over-abuse of the foot (weak foot muscles, heavy foot strain, aging, excessive time spent standing/walking, or wearing improper shoes). If you have flat feet, you probably endure significant arch pain and walk with an overpronated gait (more weight put on the inside portion of the foot). As the arch of the foot drops, more stress is put on tendons and ligaments that support the arch and pain will increase. If you suffer from flat feet you are more likely to start developing not only heel spurs, but back and hip pain as well as increased chances of ankle sprains.
- High Arches
As with flat feet, if you have high arches, you are also more likely to develop Heel Spurs (and Plantar Fasciitis). High Arches are most common in women due to the popularity of high-heel shoes and high-arches shoes. The pressure from the high arch in the shoe exerts added pressure on the plantar ligament, especially at the point where it meets the heel. This added pressure can often result in a bone spur growth.
- Muscle Imbalances
Muscle Imbalances almost anywhere in the body can and will result in an unbalanced gait. As mentioned before, an unbalanced gait will exert excess pressure on some areas of the foot (and often knee and hip); it is this excess pressure on either the ball of the foot or the heel that can easily initiate the growth of a heel spur. The odds of this happening increase over time - for chronic muscle imbalances that affect gait, you will likely end up with tendinitis in the foot, plantar fasciitis and/or heel spurs.
Muscle imbalances is a term that could mean many things. Typically a muscle imbalance is due to tight, weak or shortened muscle, often due to injury, chronic disease or overcompensation from another injury.
Poor biomechanics affect the way your foot hits the ground. If you overpronate (feet roll inward) you tend to have flat feet (pes planus), which increases stress on the heel bone.
Regular shoes or high heels that are too tight or don't support your heel or arch affect the distribution of your body weight on your foot
Health conditions such as obesity, inflammatory diseases (rheumatoid arthritis, ankylosing spondylitis), bursitis, neuroma (nerve growths), gout, diabetes, Haglund's deformity, and Achilles tendinitis can also instigate heel spurs.
If you are running or jogging on hard surfaces, especially without adequate shoe cushioning, your risk of developing heel spurs is high. Also, repetitive striking of the heel bone (ie. stomping on something with your heel) will provoke a heel spur response due to over-stressing of the heel.
You may or may not experience any symptoms with your heel spurs. It is normally the irritation and inflammation felt in the tissues around your heel spur that cause discomfort.
Heel pain is one of the first things you may notice, especially when pushing off the ball of your foot (stretches the plantar fascia). The pain can get worse over time and tends to be stronger in the morning, subsiding throughout the day; although it does return with increased activity.
A sharp, poking pain in your heel that feels like you're stepping on a stone can often be felt while standing or walking. You will sometimes be able to feel a bump on the bottom of your heel, and occasionally bruising may appear.
Your doctor will discuss your medical history and will examine your foot and heel for any deformities and inflammation (swelling, redness, heat, pain). He/she will analyze your flexibility, stability, and gait (the way you walk). Occasionally an x-ray or blood tests (to rule out diseases or infections) may be requested.
Treatment and Prevention
Heel spurs are considered a self-limited condition, which means that by making small alterations in your lifestyle and regular routines you can often control the condition. Many heel spurs go undiagnosed and/or cause no pain or discomfort, and your physician will tell you that surgical removal of a heel spur is unnecessary if you are not in pain or inconvenienced by it. To get rid of pain and inflammation from heel spurs, the goal is to reduce friction and transfer pressure from your sensitive foot areas. By addressing the reason why you got heel spurs(i.e. plantar fasciitis, losing weight) your body will no longer have a reason to continue building the spur. This will also reduce inflammation caused by your heel spur. Failure to see improvements after conservative treatments may make surgery your only option.
Cold Compression Therapy
When you are experiencing pain, swelling, and inflammation in the bottom of your foot, doctors recommend cold compression therapy. Cold compression therapy reduces tissue damage caused by swelling and inflammation and treats your foot pain quickly.
Cold compression therapy works by interrupting and slowing nerve and cell function in the damaged area. This is important because once blood vessels are damaged, they can no longer carry oxygenated blood to the heel and surround tissue and tissue cells begin to break-down.
The Plantar/Spur Freezie Wrap® allows you to treat yourself in an effective and convenient way and the deep cold provided by the Plantar/Spur Freezie Wrap® slows cell function thereby reducing cellular break-down. Furthermore, because the cold wraps serve to numb the nerves, the wraps also reduce pain!
The cooling gel pack inside every Freezie Wrap® have been designed with ColdCure Technology®. The specially formulated gel allows the pack to be supercharged in the fridge, not in the freezer like ice or other freezer packs. The Freezie Wrap® gives you deep cold compression therapy without the risk of 'cold burns' or cryoburn to the layers of your skin. This unique technology, inside a soft and completely adjustable neoprene wrap, gives you comfortable, convenient, and effective cold compression therapy.
Click here to learn more about ColdCure Technology®
Blood Flow Stimulation Therapy™
Once inflammation and swelling have been reduced in your heel and plantar fascia, nourishing and strengthening the tissue in your foot is the goal. Blood Flow Stimulation Therapy™ (BFST®) promotes blood flow to the treatment area bringing the necessary oxygen and nutrients to your tendons and ligaments and other weakened tissue. BFST® speeds up the body's natural repair process for faster healing and stronger tissue.
Extremities of the body, like the foot, do not receive much blood flow naturally and when you stop moving your foot because it hurts, you are not creating the natural blood flow it usually receives. With the use of Blood Flow Stimulation Therapy™ you can increase your body's blood supply.
In addition, the fresh blood flow whisks away dead cells and toxins (including lactic acid, commonly found in trigger points) that have built up from the injury leaving the area clean and better prepared for healing. Our Plantar/Spur Inferno Wrap® provides effective, non-invasive, non-addictive pain relief with no side effects.
Keeping your fascia and ligaments as healthy and strong as possible throughout the healing process will allow you to get back to your regular activities faster. The Plantar/Spur Inferno Wrap®, available exclusively from MendMeShop®, provides effective, non-invasive, non-addictive pain relief and healing with no side effects.
The benefits of BFST® do not end once your foot pain stops! Even when your plantar fascia has healed, your activities can put it at risk of an overuse injury, tightness, or another tear. An Inferno Wrap® treatment before activity is an easy way to warm up the tissues and prepare them for use. Then, end your day with another treatment to prevent tightness from setting in overnight. This incredible healing tool will be the ticket to healthy feet for years to come!
Click here to learn more about BFST®
Other Conservative Treatments
Properly sized footwear (leave a 1/2 inch space between longest toe and inside of shoe) with significant arch support and motion control. Also, avoid running around barefoot, or on hard and uneven ground.
Corrective footwear, orthotics (insoles and arch supports) or other foot devices (walking casts, night splints) provide support and alignment.
Cushioning or supportive items, such as taping or donut-shaped heel cushions protect, reposition your foot, and relieve pressure pain.
Exercises that stretch and strengthen your foot (flexor digitorum brevis and quadratus plantae), ankle (achilles tendon) and leg muscles (soleus, gastrocnemius, hamstring) keep you balanced and flexible.
Gentle foot massage helps relax tissues; physio therapy, chiropractic care, reflexology and acupressure are effective in relieving tension, strengthening your foot and helping with alignment.
A balanced diet keeps your weight maintained.
Some Conservative Treatment Methods can be Risky
Your doctor should limit your injections, multiple cortisone steroid injections can cause the plantar fascia to rupture (tear), which can lead to a flat foot and chronic pain. Most side effects are temporary, but skin weakening (atrophy) and lightening of the skin (depigmentation) can be permanent. (reference: PubMed - US National Library of Medicine National Institutes of Health)
Pain and anti-inflammatory medications can help relieve some aches and pains but should never be used long team.
Heel or plantar fasciitis surgery (endoscopic plantar fasciotomy, open heel-spur fasciotomy) helps to relieve pressure, reduce pain and remove the calcium spur from the heel area. However, surgery is not a guarantee and there can be complications. If the plantar fascia is not repaired when the heel spur is removed, it is likely it will return.
Recovery from heel spurs can take between 6 weeks - 18 months, depending on the severity of your condition and your commitment to proper rehabilitation. The more dedicated you are with your treatments, the faster you will see successful, long-lasting results.
See Plantar Fasciitis for more detailed information.
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