A common cause of heel pain is the heel spur, which is a bony growth on the underside of the heel bone. The spur, visible by X-ray, appears as a protrusion that can extend forward as much as half an
inch. When there is no indication of bone enlargement, the condition is sometimes referred to as ?heel spur syndrome.?
Heel spurs result from strain on the muscles and ligaments of the foot, by stretching of the long band of tissue that connects the heel and the ball of the foot, and by repeated tearing away of the
lining or membrane that covers the heel bone. These conditions may result from biomechanical imbalance, running or jogging, improperly fitted or excessively worn shoes, or obesity. Heel spurs
specifically relate to the bony spurs (extra bony growth) that form at the base of the heel. It is a ?spike? of bone that grows from the base of the heel.
At the onset of this condition, pain and swelling become present, with discomfort particularly noted as pushing off with the toes occurs during walking. This movement of the foot stretches the fascia
that is already irritated and inflamed. If this condition is allowed to continue, pain is noticed around the heel region because of the newly formed bone, in response to the stress. This results in
the development of the heel spur. It is common among athletes and others who run and jump a significant amount.
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.
A Heel Spur diagnosis is made when an X-ray shows a hook of bone protruding from the bottom of the foot at the point where the plantar fascia is attached to the heel bone. The plantar fascia is the
thick, connective tissue that runs from the calcaneus (heel bone) to the ball of the foot. This strong and tight tissue helps maintain the arch of the foot. It is also one of the major transmitters
of weight across the foot as you walk or run. In other words, tremendous stress is placed on the plantar fascia.
Non Surgical Treatment
The heel pain associated with heel spurs and plantar fasciitis may not respond well to rest. If you walk after a night's sleep, the pain may feel worse as the plantar fascia suddenly elongates, which
stretches and pulls on the heel. The pain often decreases the more you walk. But you may feel a recurrence of pain after either prolonged rest or extensive walking. If you have heel pain that
persists for more than one month, consult a health care provider. He or she may recommend conservative treatments such as stretching exercises, shoe recommendations, taping or strapping to rest
stressed muscles and tendons, shoe inserts or orthotic devices, physical therapy. Heel pain may respond to treatment with over-the-counter medications such as acetaminophen (Tylenol), ibuprofen
(Advil), or naproxen (Aleve). In many cases, a functional orthotic device can correct the causes of heel and arch pain such as biomechanical imbalances. In some cases, injection with a corticosteroid
may be done to relieve inflammation in the area.
When chronic heel pain fails to respond to conservative treatment, surgical treatment may be necessary. Heel surgery can provide relief of pain and restore mobility. The type of procedure used is
based on examination and usually consists of releasing the excessive tightness of the plantar fascia, called a plantar fascia release. Depending on the presence of excess bony build up, the procedure
may or may not include removal of heel spurs. Similar to other surgical interventions, there are various modifications and surgical enhancements regarding surgery of the heel.