Heel spurs are new bone that forms in response to stress to the heel. They serve to protect the bone against the development of microfractures. Spurs start out as cartilage and progress to solid
bone. They are present in about 50 percent of the population, yet not everyone has heel pain- that's the first clue that heel spurs don't always cause heel pain.
Each time we take a step forward, all of our body weight first rests on the heel of one foot. As our weight moves forward, the entire foot begins to bear the body's weight, and the foot flattens and
this places a great deal of pressure and strain on the plantar fascia. There is very little ?give? to the plantar fascia, so as it stretches only slightly, it pulls on its attachment to the heel. If
the foot is properly aligned this pull causes no problems. However, if the foot is ?pronated?(the foot rolls outward at the ankle, causing a break down of the inner side of the shoe), the arch falls
excessively, and this causes an abnormal stretching of the relatively inflexible plantar fascia, which in turn pulls abnormally hard on the heel. The same pathology occurs with ?supination? (the
rolling inward of the foot, causing a break down of the outer side of the shoe). Supinated feet are relatively inflexible; usually have a high arch, and a short or tight plantar fascia. Thus as
weight is transferred from the heel to the remainder of the foot, the tight plantar fascia hardly stretches at all, and pulls with great force on its attachment to the heel. In both cases, the
abnormal stress placed on the attachment of the plantar fascia to the heel usually causes pain, inflammation, and possibly swelling. If this process continues, the plantar fascia partially tears away
from the heel. The body will fill in this torn area with calcium; eventually it becomes bone, and a heel spur results.
The pain caused by a calcaneal spur is not the result of the pressure of weight on the point of the spur, but results from inflammation around the tendons where they attach to the heel bone. You
might expect the pain to increase as you walk on the spur, but actually it decreases. The pain is most severe when you start to walk after a rest. The nerves and capillaries adapt themselves to the
situation as you walk. When you rest, the nerves and capillaries rest, also. Then, as you begin to move about again, extreme demands are made on the blood vessels and nerves, which will cause pain
until they again adjust to the spur. If excessive strain has been placed on the foot the day before, the pain may also be greater. A sudden strain, as might be produced by leaping or jumping, can
also increase the pain. The pain might be localized at first, but continued walking and standing will soon cause the entire heel to become tender and painful.
Sharp pain localized to the heel may be all a doctor needs to understand in order to diagnose the presence of heel spurs. However, you may also be sent to a radiologist for X-rays to confirm the
presence of heel spurs.
Non Surgical Treatment
Exercise. If you think your pain is exercise-related, change your exercise routine, environment, or foot-ware, and emphasize movements and/or body parts that do not cause pain. Mind/Body.
Occasionally foot pain can be related to stress. The body may respond with generalized tension that contributes to pain in many areas, including the feet. Hypnosis and guided imagery are worth
exploring if an anatomical problem is not apparent. Supplements. Natural anti-inflammatories can be just as effective as ibuprofen or other over-the-counter pain relievers with fewer side effects.
Try one of the following. Ginger (Zingiber officinale) standardized to 5-6% gingerols and 6% shogoals, take one to two 500 mg tablets three to four times daily. Turmeric (Curcuma longa) standardized
to 95% curcuminoids, take 400-600 mg three times daily. Also, be sure that you're wearing well-fitting shoes, the proper shoes for each activity, and that you buy new foot-ware as soon as you notice
signs of wear. You can also take the pressure off your heel with a donut-shaped heel cushion or a heel-raising pad placed in your shoe. Acupuncture can also relieve the pain, as can for some
sufferers, magnetic shoe inserts, although the evidence behind their effectiveness is not conclusive. Osteopathic or chiropractic manipulation can help with soft tissue pain in and around the
Heel spur surgery should only be considered after less invasive treatment methods have been explored and ruled insufficient. The traditional surgical approach to treating heel spurs requires a
scalpel cut to the bottom of the food which allows the surgeon to access the bone spur. Endoscopic plantar fasciotomies (EPF) involve one or two small incisions in the foot which allow the surgeon to
access and operate on the bone spur endoscopically. Taking a surgical approach to heel spur treatment is a topic to explore with a foot and ankle specialist.
Choose new shoes that are the right size. Have your foot measured when you go to the shoe store instead of taking a guess about the size. Also, try on shoes at the end of the day or after a workout,
when your feet are at their largest. To ensure a good fit, wear the same type of socks or nylons that you would normally wear with the type of shoe that you are trying on.