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A heel spur is an abnormal growth of the heel bone, the largest bone in the foot which absorbs the greatest amount of shock and pressure. Calcium deposits form when the plantar fascia pulls away from the heel area, causing a bony protrusion, or heel spur to develop. The plantar fascia is a broad band of fibrous tissue located along the bottom surface of the foot that runs from the heel to the forefoot. Heel spurs can cause extreme pain in the rearfoot, especially while standing or walking.
An individual with the lower legs angulating inward, a condition called genu valgum or "knock knees," can have a tendency toward excessive pronation. As a result, this too can lead to a fallen arch resulting in plantar fascitis and heel spurs. Women tend to have more genu valgum than men do. Heel spurs can also result from an abnormally high arch. Other factors leading to heel spurs include a sudden increase in daily activities, an increase in weight, or a change of shoes. Dramatic increase in training intensity or duration may cause plantar fascitis. Shoes that are too flexible in the middle of the arch or shoes that bend before the toe joints will cause an increase in tension in the plantar fascia and possibly lead to heel spurs.
An individual with the lower legs turning inward, a condition called genu valgus or "knock knees," can have a tendency toward excessive pronation. This can lead to a fallen arch and problems with the plantar fascia and heel spurs. Women tend to suffer from this condition more than men. Heel spurs can also result from an abnormally high arch. Other factors leading to heel spurs include a sudden increase in daily activities, an increase in weight, or a thinner cushion on the bottom of the heel due to old age. A significant increase in training intensity or duration may cause inflammation of the plantar fascia. High-heeled shoes, improperly fitted shoes, and shoes that are too flexible in the middle of the arch or bend before the toe joints will cause problems with the plantar fascia and possibly lead to heel spurs.
A thorough medical history and physical exam by a physician is always necessary for the proper diagnosis of heel spurs and other foot conditions. X rays of the heel area are helpful, as excess bone production will be visible.
Non Surgical Treatment
The key for the proper treatment of heel spurs is determining what is causing the excessive stretching of the plantar fascia. When the cause is over-pronation (flat feet), an orthotic with rearfoot posting and longitudinal arch support is an effective device to reduce the over-pronation, and allow the condition to heal. Other common treatments include stretching exercises, losing weight, wearing shoes that have a cushioned heel that absorbs shock, and elevating the heel with the use of a heel cradle, heel cup, or orthotic. Heel cradles and heel cups provide extra comfort and cushion to the heel, and reduce the amount of shock and shear forces experienced from everyday activities.
Though conservative treatments for heel spurs work most of the time, there are some cases where we need to take your treatment to the next level. Luckily, with today?s technologies, you can still often avoid surgery. Some of the advanced technologies to treat a Heel Spur are Platelet Rich Plasma Therapy. Platelet Rich Plasma Therapy (also known as PRP) is one of several regenerative medicine techniques that University Foot and Ankle Institute has helped bring to foot and ankle care. This amazing in-office procedure allows the growth factors in the blood to be used to actually begin the healing process again long after your body has given up on healing the area. Heel Pain Shockwave Therapy. Shockwave therapy is a non-invasive procedure done in the office that allows for new blood to get to the region of fascia damage and help with healing. Results have been excellent with more than 70 percent of patients getting relief with only one treatment. Topaz for Heal Spurs and pain. Another minimally invasive technology technique is called Coblation Surgery using a Topaz probe. This minimally invasive procedure involves controlled heating of multiple tiny needles that are inserted through the skin and into the plantar fascia. This process, like PRP and Shockwave therapy, irritates the fascia enough to turn a chronic problem back into an acute problem, greatly increasing the chances of healing. Heel Spur Surgery. Endoscopic Plantar Fasciotomy is one surgical procedure that we consider to release the tight fascia. University Foot and Ankle Institute has perfected an endoscopic (camera guided) approach for fascia release to allow rapid healing and limited downtime with minimal pain.
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