Called calcaneal spur in medical parlance, a heel spur is a small protrusion (or osteophyte) that occurs on the heel bone.
Heel spurs can be of two types:
• Inferior calcaneal spur - These spurs are located on the inferior side of the heel bone and are usually caused by ankylosing spondylitis (a hereditary disease which causes painful inflammation in the joints around the spine), especially in children. They consist of calcium deposits along the heel bone, which is located superior to the plantar fascia.
• Posterior calcaneal spur - These bony projections develop on the back side of the heel, at the insertion of the Achilles tendon. Posterior spurs are usually larger and are usually visible to the naked eye.
When the muscles and ligaments of the foot are subject to constant stress and strain, calcium deposits start building up on the undersurface of the heel bone.
Stretching of plantar fascia (Plantar fascia, for a layman, is the layer of thick tissue that supports the arch at the base of the foot) over a period of time or repeated damage caused to the membrane covering the heel bone results in the building up of these deposits and causes a hook shaped deformity in the bone. Deposit building is a long and gradual process that takes place over a period of several months. These deposits eventually cause heel spurs.
Who can get heel spurs?
People who are more likely to get heel spurs include:
• Women- Since most women wear high heels, greater pressure is exerted on their tissues and this makes them more vulnerable to heel spur than men.
• Flat-footed people- People ho have flat-feet are more likely to get heel spurs.
• Athletes and sports persons- Since the activities of athletes and sports persons include a lot of jumping and running, their tissues are subject to constant stress. Running regularly on hard surfaces is likely to make matters worse.
• Over-weight people- Obese and over-weight people are also more likely to develop heel spur.
• People with gait abnormalities- Irregularities in gait may, at times, cause excessive stress on the heel bone and the tissues of the heel and cause spurs over a period of time.
• People wearing poor fitting shoes- Uncomfortable shoes which lack proper arch support or shoes worn improperly also cause stress to the plantar fascia.
Symptoms associated with heel spurs
Heel spurs usually cause no symptoms to appear. As such, they can be detected only by an X-ray of the affected area though the larger ones where the protrusion in the bone is almost half an inch in size are visible to the naked eye.
Most heel spurs are painless, though they might be accompanied by pain and discomfort in some cases. Such painful spur often get mistaken with plantar fasciitis (a swelling in plantar fascia characterized by acute pain).
The pain associated with heel spurs might be intermittent or continuous. Most people with spurs experience pain while jogging, jumping or running, if the area along the heel spur has an inflammation. In most cases, the cause of the pain is not the spur itself, but the injury caused to the soft tissue(s).
Usually, people with heel spur complain of a sharp pain in the heel when they get up in the morning- something like a pin prick. This pain turns into a dull ache as the day progresses.
Treatment and prevention of heel spurs
To treat heel spur, we need to pinpoint the exact cause of strain to the muscles of the affected area. Flat-footed people can try longitudinal arch supports or orthotics with rearfoot posting. Athletes could refrain from running and jogging for a few days, especially on hard surfaces. People who, because of the nature of their work, are required to stand for long periods at a stretch could try sitting intermittently to give rest to the affected muscles.
Avoiding high heels and wearing well-cushioned shoes that absorb shock also helps in the treatment of heel spur. Various types of heel cradles, heel cups and orthotics are also available these days. Besides these, stretching exercises are also known to help, though one must consult a physiotherapist before starting an exercise regime. Overweight people could try shedding a few extra pounds, though that is easier said than done.
Extreme cases might need anti-inflammatory medicines and cortisone injections. And, God forbid, if nothing works, surgery might be required