A heel spur occurs when calcium deposits build up on the underside of the heel bone. The abnormal calcium deposits form when the plantar fascia pulls away from the heel. This stretching of the
plantar fascia is common among people who have flat feet, but people with unusually high arches can also develop this problem. Heel spurs are especially common among athletes who do a lot of running
and jumping. Also, women who wear high heels have a significantly higher incidence of heel spurs. Still, it can happen to anyone.
The plantar fascia is a big strong ligament on the bottom of the foot, starting at the bottom of the heel bone and running into the ball of the foot. As the arch of the foot becomes weak, it sags
slightly with each step and this causes the plantar fascia to tug and pull at the heel bone with each step. Over a period of time, a spur forms where this big strong ligament tugs and pulls at the
heel bone. Soon, inflammation (swelling) starts around this spur and the pain becomes almost unbearable. (Sometimes heel spurs may be present without being painful if no inflammation is
The following symptoms are typical of heel spur. Stabbing pain when treading on the area affected. Dull, irregularly occurring pains in the heel area also without exerting pressure (e.g. in a
reclining position) Pain when taking the first steps in the morning (after lying or sitting down for an extended period, especially in the morning) Occasional swelling in the ankle area. For the
lower heel spur, extreme sensitivity at the tendon attachment (laterally in the lower heel area) For the upper heel spur, extreme pressure sensitivity of the Achilles tendon, primarily at
approximately ankle height.
Because the diagnosis of heel spurs can be confused with tarsal tunnel syndrome (as described earlier), most surgeons advocate performing a tarsal tunnel release (or at least a partial tarsal tunnel
release) along with the plantar fascia release. This surgery is about 80percent successful in relieving pain in the small group of patients who do not improve with conservative treatments.
Non Surgical Treatment
Many treatment options exist, and good results are often observed. Generally, a calcaneal spur develops when proper care is not given to the foot and heels. It is often seen as a repetitive stress
injury, and thus lifestyle modification is typically the basic course of management strategies. To alleviate heel spur pain, a person should begin doing foot and calf workouts. Strong muscles in the
calves and lower legs will help take the stress off the bone and thus help cure or prevent heel spurs. Icing the area is an effective way to get immediate pain relief.
In a small number of cases (usually less than 5 percent), patients may not experience relief after trying the recommendations listed above. It is important that conservative treatments (such as those
listed above) be performed for AT LEAST a year before considering surgery. Time is important in curing the pain from heel spurs, and insufficient treatment before surgery may subject you to potential
complications from the procedure. If these treatments fail, your doctor may consider an operation to loosen the plantar fascia, called a plantar fascia release.
A variety of steps can be taken to avoid heel pain and accompanying afflictions. Wear shoes that fit well-front, back, and sides-and have shock-absorbent soles, rigid shanks, and supportive heel
counters. Wear the proper shoes for each activity. Do not wear shoes with excessive wear on heels or soles. Prepare properly before exercising. Warm up and do stretching exercises before and after
running. Pace yourself when you participate in athletic activities. Don't underestimate your body's need for rest and good nutrition. If obese, lose weight.