posted on 27 Sep 2015 06:14 by juliana8decker1
Bone spurs including heel spurs occur as a natural response of the body to wear and tear. Heel spur in particular, can cause pain when it rubs against soft tissues including the Achilles tendon. When that happens movement can become restricted. Spurs can also appear in other joint areas such as under the toenail where it would lead to pain and nail deformation.
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.
Heel spur is characterised by a sharp pain under the heel when getting out of bed in the morning or getting up after sitting for a period of time. Walking around for a while often helps reduce the pain, turning it into a dull ache. However, sports, running or walking long distance makes the condition worse. In some cases swelling around the heel maybe present.
Heel spurs and plantar fasciitis are diagnosed based on the history of pain and tenderness localized to these areas. They are specifically identified when there is point tenderness at the bottom of the heel, which makes it difficult to walk barefoot on tile or wood floors. X-ray examination of the foot is used to identify the bony prominence (spur) of the heel bone (calcaneus).
Non Surgical Treatment
Initially, treatment usually consists of a combination of ice therapy, stretching exercises to improve flexibility (especially in the mornings), anti-inflammatory medications, and physical therapy. Most patients will also need custom-molded orthotics to help control the motion in the foot and arch, which takes the strain off the plantar fascia. If the pain continues, a cortisone injection may be used to calm the severe swelling and pain. There may the need for a night splint to maintain a stretch in the plantar fascia throughout the night.
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.
Heel spurs and plantar fasciitis can only be prevented by treating any underlying associated inflammatory disease.