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The heel spur, accompanying plantar fasciitis, is a painful and unpleasant degenerative ailment. The accompanying severe pain in the foot limits our mobility and sometimes even makes it impossible to walk. How are heel spurs formed and can they be prevented? What is the treatment of a heel spur?
- Heel spurs are degenerative changes
- Their formation may be caused by excessive physical effort or inappropriate selection of shoes
- They are also favored by staying in a standing position for too long
- More information can be found on the Onet homepage
Heel spur – characteristics of ailments
Heel spurs (ICD-10 M77.3, Latin calcar calcanei, in the English language specialist literature referred to as CS, i.e. calcaneal spur) are degenerative changes, most often the result of prolonged inflammation within the plantar fascia. This aponeurosis connects the calcaneus tumor to the root of the toes – it is a flexible structure made of connective tissue that tightens and relaxes when you walk. Thanks to this, the foot is adequately resilient and the arch of the longitudinal vault does not flatten.
Heel spurs usually appear around the calcaneus tumor of the calcaneus – where the plantar fascia has an attachment – and are unnatural bone growths (enthesophytes). What is the mechanism of their formation?
– The inflammatory process in the area of the tendon attachment causes additional bone tissue to form in the sensitive area. These are the heel spurs. Probably microcalcifications, which gradually turn into a spur, arise at the site of damage to individual fibers of the aponeurosis. However, they are only a symptom of the disease, not the cause of it. What’s more, the spurs in the heels can be seen on X-rays in about 50% of patients, and 20% of those who have them have never felt any pain because of this – says Paweł Kołodziejski, MD, PhD from the Foot Disease Clinic, the first center in Warsaw specializing in treatment of diseases of the foot and ankle.
Another unpleasant condition of the foot, called Haglund’s heel (or spur), is created in a similar way. This is a degeneration of the calcaneus resulting from excessive tightening of the calcaneus in the upper part, near the Achilles tendon insertion. Such a heel defect is congenital, but often does not cause any pain symptoms. They usually appear when we wear too small or too hard shoes.
Read more about Haglund’s heel: Sterile calcaneus tumor necrosis – what is it?
Heel spur – causes
The direct cause of inflammation within the plantar fascia, resulting in the formation of heel spurs, is microtrauma to this part of the body. You can get them in various ways – the most common reasons for their formation include:
- overstrain of the foot as a result of excessive physical exertion (especially without preparation in the form of a warm-up);
- incorrectly selected footwear size – too large, which forces us to tighten the toes, or too small, constricting the foot;
- inappropriate footwear that causes discomfort when walking or running, especially on hard surfaces (asphalt, concrete, blocks);
- staying in a standing position for too long;
- overweight and obesity, leading to excessive stress on the feet;
- untreated injuries to the foot or ankle, which leave the foot in an unnatural position for a long time;
- Congenital or acquired defects, such as flat feet, valgus or varus feet;
- changes in the way of walking due to advanced age – shortening of the stride length and longer contact of the heel and sole with the ground.
Interestingly, The heel spur can develop both unilaterally and bilaterallydepending on the factor causing it.
As an auxiliary in the treatment of the heel spur, you can use the OS1st FS6 compression bandage for the heel spur and ankle joint available at medonetmarket.pl in black, flesh-colored or white.
Although the correlation between gender and the tendency to develop heel spurs has not been fully confirmed, studies indicate that women under 49 struggle with this condition almost twice as often as men. According to some theories, this has to do with high-heeled shoes that women wear.
Heel spurs – symptoms
What are the symptoms of the heel spur? Symptoms are practically limited to persistent pain in the heel area. Initially, the pain occurs at stress points, when the heel is under heavy loads. Pain when trying to raise the toes upwards is also characteristic of this disease.
Over time, as the heel spurs progress, the pain becomes restful (even when we are not moving) and its intensity increases.. Usually it is located in the central part of the heel, it can be spotty or pulsating – sometimes it radiates over the entire surface of the heel. Pain associated with heel spurs are often described as burning or even burning. They can be so troublesome that the patient has problems even with putting on shoes.
Do not underestimate the pain in the heel or try to get used to it by working out the so-called new gait pattern. Many patients, ignoring the pain, try to adopt unnatural positions and mechanisms of movement while walking. This is a dangerous practice that can contribute to the destabilization of the entire skeleton and kinetic disorders and lead to further degenerative changes – not only in the foot, but also in the knees and spine.
Also read: Does your spine hurt? Feet may be the cause
Heel spurs – diagnosis
Pain in the heel does not always mean problems with the heel spur. Plantar fasciitis is relatively easy to confuse with other diseases and ailments that are manifested by pain in this area – they mainly include:
- Haglund’s disease, or aseptic necrosis of the tumor of the calcaneus (where the pain appears in the posterior part rather than in the center of the heel);
- inflammation within the Achilles tendon (e.g. bursitis or Achilles tendonitis);
- tarsal canal syndrome, which often occurs with valgus of the foot (in this case, not the plantar fascia is irritated, but the nerve branch in the area of the calcaneus tumor);
- systemic diseases, incl. psoriasis, Reiter’s syndrome, rheumatoid arthritis (RA);
- mechanical injuries of the foot: bruises, fractures, sprains.
Therefore, an appropriate diagnosis is extremely important in order to exclude or confirm that these are actually heel spurs before starting treatment.
According to Dr. Krzysztof Bryłka from the Foot Disease Clinic, the basis of diagnostics in this case is a thorough palpation (manual) of the foot, i.e. a touch testwhich allows you to find out what exactly hurts and where. It should always be preceded by a precise medical interview and the definition of, inter alia, the duration of the symptoms, intensity and onset of their occurrence, as well as factors that aggravate or alleviate the course of the disease.
If the heel spur is suspected, an X-ray scan is performed to confirm or rule out this diagnosis. Sometimes an ultrasound is also needed.
Also check: Five diseases that can be seen on the feet
In the past, one of the most commonly used methods of treating a heel spur was surgery. However, they did not give the desired results, on the contrary – they often contributed to the exacerbation of degenerative changes, and thus increased pain. Why? Dr. Krzysztof Bryłka explains:
“In the past, spurs were removed surgically, but often the effects were catastrophic, because the unique fat tissue in the heel area was destroyed, which absorbs shocks. Currently, such operations are generally not performed: exceptions are rarely made in cases of extremely refractory treatment.
The procedure involves a partial cut of the plantar fascia, which reduces the loads transferred to its attachments. However, it should be remembered that carrying out such an operation may lead to the flattening of the longitudinal arch of the foot and the formation of longitudinal flat feet. The microscopic nerve connections around the plantar fascia attachment can also be torn. “
Zobacz: Foot blisters – causes, treatment, prevention
So what can you do when you are teased by the heel spur? Treatment is usually based on comprehensive physiotherapy, which combines physical treatments and kinesiotherapy exercises. When it comes to physical therapy, most of all, treatments using the shock wave (ESWT – Extracorporeal Shock Wave Therapy). They give the best and fastest results, although they can be painful for patients with greater pain sensitivity.
How do ESWT treatments work? The site of the heel spur is treated with a mechanical wave affecting the propri- and exteroreceptors, generating high pressure and penetrating deep into the tissues. As a result, numerous microdamages are created in cell membranes, thanks to which pain information from the nervous system is received and transmitted to a limited extent. The shock wave also reduces muscle tension with additional analgesic effect.
The treatment of the heel spur can also be supported by treatments such as:
- phonophoresis, i.e. high-intensity ultrasound;
- cryotherapy (cold treatment);
- magnetotherapy (treatment that uses an alternating magnetic field);
- iontophoresis (electrotherapy involving the introduction of a special drug into the pain site via direct current).
It is worth remembering that although these treatments are less painful for the patient than the shock wave, their effect is much weaker. Therefore, you will have to wait longer for the effects than in the case of ESWT treatments.
As already mentioned, it is worth combining physical treatments with kinesiotherapeutic exercises. During such sessions, the patient learns how to properly perform exercises to stretch the plantar fascia and the surrounding muscles in order to strengthen them and prevent the progression of changes and injuries. Sometimes, to support the effects of such therapy, the so-called taping, i.e. covering the sole of the foot with special tapes. In some cases, the orthopedist (or podiatrist) also recommends manual therapy, i.e. foot massage.
An important element supporting the treatment of the heel spur are shoes adapted to the structure and physiology of the foot – flat, with a flexible and shock-absorbing sole. In addition, insoles or special orthopedic shoes help, preferably individually fitted on the basis of a podometry test. However, they are quite expensive. Gel inserts or heels (or made of soft material) can be a more economical solution.
Try Gel Heel Heels and FootWave SOFTY spurs. We also recommend orthopedic insoles for FootWave heel spurs, which you can buy at a promotional price at Medonet Market.
It is worth being aware of the fact that the best results when it comes to the treatment of a heel spur are achieved by combining physiotherapy with pharmacological treatment. The actions taken complement each other, allowing for faster recovery.
If heel spurs are still in their infancy, non-steroidal oral anti-inflammatory agents are most commonly included in treatment to help combat plantar fasciitis. Ointments and gels do not help with heel spurs, because they are not able to penetrate deeply enough into the skin and reach the place where the pain is located.
It happens that with greater intensity of pain it is necessary to use stronger steroid drugs, e.g. injections with glucocorticosteroids. However, such a situation occurs relatively rarely.
The orthopedic support for the treatment of the heel spur are compression socks for the ankle joint and OS1st FS4 heel spurs in black or gray, which you can buy at an attractive price at Medonet Market.
There are many strange alternative ways to treat your heel spur on online forums. There are many sophisticated procedures, such as wrapping the heel in bacon at night, putting walnut leaves in the shoe or … tapping on the heel with a XNUMX-centimeter wooden spoon every evening. However, one should not count on their effectiveness …
Home remedies for a heel spur that actually provide temporary relief are cold compresses or rolling the plantar fascia with a hard ball.
Heel spur – prophylaxis
Treatment of the heel spur in many cases is long-lasting and does not bring immediate results. Therefore, it is worth taking care to prevent the development of this ailment in advance. The key issue in the prophylaxis of the heel spur is undoubtedly comfortable and well-fitting footwear. It should be soft and comfortable, with a soft and stable sole. You should also avoid wearing high heels and other high heels that strain the plantar fascia.
In order to reduce the discomfort associated with the heel spur, you can use the Remove Ring heel spurs, available at Medonet Market.
It is also worth taking care of maintaining a healthy body weight – when overweight, the heels are overloaded, which promotes the development of inflammation. When practicing sports that involve the feet strongly, you should always remember to warm up properly to minimize the risk of injury. You should also avoid standing for too long (if possible).
Read also: Shoes break bones