 WHAT IS A HEEL SPUR?
The heel bone is the largest
bone in the foot and absorbs the
most stress. A heel spur is an
abnormal growth of bone either
at the back of the heel, or most
commonly on the bottom of the
heel. The most common symptom
of a heel spur is to have pain when
first getting out of bed in the
morning, or after resting for 20
minutes then getting up.
WHY DO WE GET HEEL
SPURS OR HEEL SPUR SYNDROME?
The most common reasons for
heel spurs and heel pain is due to
excessive stress
and stains applied
to the heel bone and the
soft tissues structures that attach
to the heel bone when we
walk. This abnormal stress and
strain is caused by Abnormal Pronation, which is the result
of having a Morton's Toe. Our
modern-day society,
where many jobs demand long
hours of standing on hard concrete,
that are unforgiving on our feet also contributes to heel problems.
Over a period of years one of
the major structures attached
to the heel called the plantar
fascia (this is the large rubber
band structures that hold up
your arch, and that goes from
the heel to the ball of the foot)
pulls away from the calcaneus
(heel bone) and causes
microscopic bleeding to occur.
This bleeding can lead to new bone
formation at the heel which
eventfully leads to the formation of
a bone spur. "Heel Spur Syndrome"
is pain of the heel when the
plantar fascia is just pulling
abnormally at the heel without a
spur being formed. Besides
the heel itself being affected, there
is a fluid containing sac covering
the heel called a bursa. The
bursa acts as a shock absorber
for the tremendous forces that
goes through the heel. This
bursa will get abnormally swollen and
inflamed when the heel is injured
as noted above, resulting in a
Bursitis. The medical term for
this is a Calcaneal Bursitis and
is the cause of the pain upon
getting out of bed in the morning
or pain upon raising after resting,
either at the heel spur on
the bottom and or back of
the heel bone.
Plantar Fasciitis is a condition
where the plantar fascia
gets swollen and inflamed, again
due to abnormal pronation.
Normally it hurts upon standing
but normally goes away walking
awhile. Surgery is very rare, and
conservative treatment is the
same as heel spur (see below)
Other causes of heel pain include:
physical injury, obesity,
poor shoes, muscle inflammation,
Gout, nerve problem (Tarsal
Tunnel Syndrome,) strain of the
plantar arch, Arthritis or
simply excessive
walking or standing.
I am of the firm belief that heel
spurs lay dormant for years like
volcanos. One of the most
amazing thing about heel spurs is
that at this very moment there
are millions of people walking
around the world who have
massive heel spurs
who are not having
one drop of pain, and have no
idea in the world that they have
heel spurs. Many people go thru
their entire life with heel spurs
who don't have any heel pain.
It is not unusual for me to see a
patient who complains of heel
pain of about 2-3 months, to have a
spur on x-ray that from its size,
had to have been
there for 20 years.
Again I believe something will
trigger the heel pain out of the
blue when a large spur has been
there for many years.
Self-treatment in the early stages
of heel pain may include
stretching exercises, elevation
of the heel, using over the
counter anti-inflammatory medications,
ice or heat (I prefer heat), losing
weight, padding the heel with a
soft foam rubber material, or
wearing shoes with a thick
rubber heel which act
as a shock absorber.
If the condition does not
respond to such treatment,
it is time to consult a podiatrist
who will compile a careful medical
history and perform a detailed
examination of the foot. X-rays
are normally needed
to assist in
determining the nature of the
problem. At the
Ambulatory Foot
Clinic we also employ
Thermography in all of
our exams for heel pain
This allows us to see
inside your foot and see
your pain. There are only a
handful of foot specialist in
the Southeast who have this
state of the art ability
in their offices.
Children can also have severe
heel problems.
Between the ages of
9 and 13 they can
experience pain
on the side of the heel caused
by an irritation to the growth plate,
and is called Calcaneal
Apophysitis, or Sever's Disease.
This condition can become
serious and should
be immediately
evaluated by a podiatrist.
Heel spurs and heel pain is the
most common problems seen at the
Ambulatory Foot Clinic-Podiatric Pain Management Center.
Our treatments for
these complex problems are
not to give painful injections
or perform surgeries immediately,
but instead use the time proven,
highly successful, relatively pain free
treatments such as
stress free
Physical Therapy, medications
and removal of the abnormal
stress and strain on the heel (which
were and are the real cause of
the problem) with padding and
strapping and then Orthotics
to control the underlying
Abnormal Pronation which many times is due to Morton's Toe.
There are many highly successful
non-surgical treatments for heel
spurs and related conditions that
give long term relief by treating
the abnormal bone pressure. Foot
surgery for heel pain is rare and
should always be a last resort, but if
needed, it is done using
minimal incision techniques, in
the comfort and privacy of our Clinic.
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