If you suffer from heel pain, you know that it affects every step you take. And by the time you take off your shoes in the evening, your feet are really suffering. The pain you?re feeling could be
caused by heel bone spurs. Heel bone spurs are common in people who walk, stand or run on hard surfaces such as concrete or tile floors-and that?s most of us! This kind of frequent, intense impact on
hard surfaces overstretches and can even tear the ligaments on the bottom of the foot, a condition known as plantar fasciitis. In extreme cases, these ligaments begin to pull away from the bone. Heel
bone spurs are created because of this injury to the foot. They are not painful by themselves, but they do irritate surrounding tissues, which causes heel pain.
One frequent cause of heel spurs is an abnormal motion and mal-alignment of the foot called pronation. For the foot to function properly, a certain degree of pronation is required. This motion is
defined as an inward action of the foot, with dropping of the inside arch as one plants the heel and advances the weight distribution to the toes during walking. When foot pronation becomes extreme
from the foot turning in and dropping beyond the normal limit, a condition known as excessive pronation creates a mechanical problem in the foot. In some cases the sole or bottom of the foot flattens
and becomes unstable because of this excess pronation, especially during critical times of walking and athletic activities. The portion of the plantar fascia attached into the heel bone or calcaneous
begins to stretch and pull away from the heel bone.
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.
A thorough history and physical exam 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
Non Surgical Treatment
In many cases treatment is non-surgical and can relieve pain, but may take from three months to a year to fully recover. Performing stretching exercises to help relax the tissues in the heel as well
as rest, icing, and over-the-counter anti-inflammatory or prescription medications can help ease symptoms. Customized orthotics or shoe inserts to position and cushion your heel can help.
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
Prevention of heel spur syndrome may be best by finding a good supportive shoe. Never go barefoot or wear a flat soled shoe. There are many over the counter arch supports that give increased support
for your feet. Usually when there is excessive pronation the Achilles Tendon contracts or becomes shortened over time since it is not being used fully. The shortened Achilles Tendon is called an
equinus deformity. By keeping this tendon stretched it may decrease some of the tension in the foot. Some theories believe the Achilles Tendon and plantar fascia is continuous. Before you get up from
rest, stretch out your Achilles and the plantar fascia. You may attempt to spell the alphabet with your foot and ankle, use a towel against pressure on your foot, or roll a can of soup or sodapop on
the ground. Ice may work well at the times of severe pain. For a chronic pain, or longer lasting pain heat therapy may improve the condition.