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  /  Ankle   /  Heel Spurs: Causes, Symptoms, and Treatments

Heel Spurs: Causes, Symptoms, and Treatments

Heel spurs, also known as calcaneal spurs, are a common source of heel pain that can affect people of all ages. While they are often associated with discomfort and limited mobility, advancements in medical research have shed new light on the causes, symptoms, and treatment options for this condition. In this blog post, we’ll discuss heel spurs, while relying on recent research, in order to provide a thorough explanation of this condition

Symptoms

Heel spurs are bony protrusions that develop on the underside of the heel bone or along the back of the heel. These growths can range in size from a few millimeters to more than an inch. Notably, many individuals with heel spurs do not experience pain, and the condition is often detected incidentally through X-rays. However, for those who do experience symptoms, the following are common:

  • Pain: Heel spur pain typically manifests as a sharp, stabbing sensation in the heel, particularly when bearing weight on the affected foot.
  • Inflammation: The surrounding tissues may become inflamed, leading to redness and swelling in the heel area.
  • Difficulty Walking: Pain and discomfort can make walking or standing for prolonged periods challenging.
  • Tenderness: The heel may become tender to the touch, making it painful to apply pressure, even when not walking.

Causes and Risk Factors

Heel spurs develop as a result of calcium deposits that accumulate over time on the heel bone. The most common underlying causes and risk factors include:

  • Plantar Fasciitis: The majority of heel spurs are associated with plantar fasciitis, a condition characterized by inflammation of the plantar fascia, a thick band of tissue that connects the heel bone to the toes.
  • Excessive Strain: Activities that place repetitive strain on the heel and plantar fascia, such as running, dancing, or being overweight, can increase the risk of developing heel spurs.
  • Age: Heel spurs are more common in individuals over the age of 40, as the plantar fascia tends to lose elasticity and resilience with age.
  • Foot Structure: Abnormal foot structure or biomechanical issues, such as high arches or flat feet, can lead to an increased risk of heel spurs.

Non-Surgical Treatments

Many individuals with heel spurs find relief through non-surgical treatments. Recent studies have highlighted the effectiveness of these conservative approaches:

  • Anti-Inflammatory Medications: Prescribed non-steroidal anti-inflammatory drugs (NSAIDs) can help manage pain and inflammation.
  • Orthotic Devices: Custom-made or over-the-counter orthotic insoles can provide better arch support and reduce strain on the heel.
  • Shockwave Therapy: Extracorporeal shockwave therapy (ESWT) is a non-invasive option that uses shockwaves to stimulate healing and reduce pain.
  • PRP and Stem Cell Therapy: Platelet-rich plasma (PRP) and stem cell therapy are emerging treatments that harness the body’s natural healing processes to alleviate pain and promote tissue repair.
  • Physical Therapy:  Physical therapy plays a crucial role in the conservative management of the condition; helping in reducing pain, improving mobility, and preventing the recurrence of heel spurs.

Physical therapy

Here are some key components of physical therapy management:

  • Stretching and Strengthening Exercises: Physical therapists design tailored exercise programs to address specific issues. Stretching exercises target the calf muscles and Achilles tendon to alleviate tension on the plantar fascia. Strengthening exercises focus on improving foot and ankle strength; this can help support the arch and reduce strain on the heel.
  • Manual Therapy Techniques: Recent research has shown that manual therapy techniques, such as deep tissue massage and joint mobilization, can effectively relieve pain and improve tissue flexibility in individuals with heel spurs. These hands-on approaches help reduce muscle tension and promote blood flow to the affected area.
  • Patient Education: Educating patients about proper foot care and footwear choices is a fundamental aspect of physical therapy management. The patient should know the importance of wearing supportive footwear with adequate arch support and cushioning to prevent exacerbation of heel spur symptoms.
  • Home Exercise Programs: To facilitate long-term management and prevention of heel spurs, physical therapists often prescribe home exercise programs tailored to the patient’s needs. These exercises are designed to maintain flexibility and strength in the foot and ankle.
  • Functional Rehabilitation: For individuals with more severe cases of heel spurs or those who have undergone surgical procedures, physical therapy is crucial for postoperative rehabilitation. Physical therapists guide patients through a gradual return to weight-bearing activities and sports.

Surgical Treatment

In some cases, non-surgical treatments may not provide sufficient relief, and surgical intervention may be necessary. This includes:

  • Endoscopic Plantar Fasciotomy: This minimally invasive procedure involves cutting the plantar fascia to release tension and remove the spur.
  • Open Surgery: In more severe cases, open surgery may be required to remove the heel spur and repair any damaged tissue.

Conclusion

In conclusion, heel spurs can cause significant discomfort and affect daily activities. Non-surgical treatments are often effective, but for those with severe symptoms, surgical interventions provide hope for relief and improved quality of life. If you’re experiencing heel pain, consult a healthcare professional to explore the most suitable treatment approach tailored to your needs.

References

American Academy of Orthopaedic Surgeons. (2021). Heel Spurs.

Mayo Clinic. (2021). Heel spurs.

Hawke, F., & Burns, J. (2009). Understanding the nature and mechanisms of foot pain. Journal of Foot and Ankle Research, 2, 1.

Ogden, J. A. (2008). Radiology of postnatal skeletal development. Skeletal Radiology, 37(3), 195-202.

Landorf, K. B., & Menz, H. B. (2008). Plantar heel pain and fasciitis. BMJ Clinical Evidence, 2008, 1111.

Digiovanni, B. F., et al. (2003). Plantar fascia-specific stretching exercise improves outcomes in patients with chronic plantar fasciitis: a prospective clinical trial with two-year follow-up. Journal of Bone & Joint Surgery, 85(7), 1270-1277.

Rathleff, M. S., et al. (2014). High-load strength training improves outcome in patients with plantar fasciitis: a randomized controlled trial with 12-month follow-up. Scandinavian Journal of Medicine & Science in Sports, 25(3), e292-e300.

 

 

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