Identifying Posterior Calcaneal Spur

Heel Spur

Overview

Heel spur is a hook of bone that protrudes from the bottom of the foot where plantar fascia connects to the heel bone. Pain associated with heel spurs is usually pain from plantar fasciitis, not the actual bone. Heel spurs are most often diagnosed when a patient has visited a pain specialist or podiatrist for on-going foot pain related to plantar fasciitis; spurs are diagnosed via X-ray of the foot. Heel spurs are most commonly diagnosed in middle-aged men and women. As noted, most patients with this condition have other podiatry-related pain. This condition is a result of plantar fasciitis (when the fascia, a thick connective tissue that connects the heel bone and ball of the foot) becomes inflamed. Some 70% of plantar fasciitis patients have a bone spur. Bone spurs are soft calcium deposits caused from tension in the plantar fascia. When found on an X-ray, they are used as evidence that a patient is suffering from plantar fasciitis. Plantar fasciitis is typically caused from repetitive stress disorder. Walking, running, and dancing can cause this with time.

Causes

When the Plantar Fascia is allowed to rest during sleep or long periods of inactivity, the fascia tightens and shortens. When you first stand up after resting, the fascia is forced to stretch very quickly causing micro-tears in the tissue. This is why the first steps in the morning are so exquisitely painful. Heel spurs are more likely to happen if you suffer from over-pronation (walking with a rolling gait) you stand or walk on rigid surfaces for long periods, you are above ideal weight or during pregnancy, you have stiff muscles in your calves.

Inferior Calcaneal Spur

Symptoms

Heel spurs can be quite painful, but can just as likely occur with no symptoms at all. Plantar fasciitis is a contributing condition to heel spurs. The cause of the pain is not the heel spur itself but the soft-tissue injury associated with it. The feeling has been described as a knife or pin sticking into the bottom of your feet when you first stand up after sitting or laying down for a long period of time - a pain that later turns into a dull ache.

Diagnosis

The proper diagnosis of a heel spur often requires an X-ray. To make this process as convenient for his patients as possible, most clinics have an on-site digital X-ray and diagnostic ultrasound machines. This can make it unnecessary for patients to visit diagnostic imaging centers, allowing patients to receive more expedient treatment.

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 rear foot 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.

Surgical Treatment

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.

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