Heel Spur Surgery
When heel pain makes life miserable and all conservative treatments fail to provide relief, heel spur surgery might be the only option you have.
Though most calcaneal spurs can be quite harmless, some of them have the potential to cause debilitating pain and disrupt normal life, especially if left unattended. People who have suffered from excruciating pain on account of heel spur and have not had any luck with exercises, hot packs, ice packs, oral medicines and cortisone injections will be glad to know that all is not lost for them and that they can take the help of heel spur surgery and move on with life.
Heel spur surgery can be of two types:
Invasive surgery, and
There are many invasive surgery methods that can be used to ease the suffering caused by a stubborn heel spur:
Scalpel based treatments: This is one of the oldest surgical methods for treating a heel spur. The surgeons detach the plantar fascia ligament from the place it is attached to the heel bone by making a small incision. There are no cameras to guide the surgeon and the patient has no option but to trust the surgeon’s capabilities and instinct completely. The surgeons use a scalpel to snap the plantar fascia off the heel bone once they are sure they have identified it with the help of an x-ray.
Endoplasmic plantar fasciotomy: This is a newer option for providing relief to heel spur patients. It usually involves making one or two incisions (cuts) around the side of the heel which allow the doctor to insert a plastic tube, through which a camera and a scalpel can be inserted. With the camera to guide him, the doctor can cut the trouble causing part of plantar fascia with the hope of reducing the pressure on the tissues of the area and alleviating pain. The surgeon has greater control while performing the surgery and knows for sure what part of the plantar fascia is to be detached from the heel bone, and from where. The incision creates a gap and the new tissue that grows in its place usually adapts to the patient’s body.
The whole process takes less than an hour and does not require any hospitalization. The patient is required to wear specially designed shoes for 3-5 days after the surgery before he can start wearing his usual shoes. Most patients get back to work after a week, though results vary from individual to individual.
Removing the spurs completely: After making one or two cuts along the heel, the surgeon may decide to remove the bony calcium projection which has been causing trouble.
Healing period: Invasive heel spur surgery would involve a healing period of 1-3 weeks and during this period, the patient has to take care to avoid standing for long periods of time, strenuous activity and from lifting heavy loads.
Possible complications: Invasive procedures have usually yielded good results, but complications may arise in the form of:
As with any surgery, infection is always a possibility. Wetting the affected area can further increase the chance of infection.
If the patient does not take adequate rest and walks on the operated foot during the healing period, he might cause permanent damage to the underlying tissues.
If the ligament does not get completely detached during the course of surgery, pain will resurface after some time.
A damage caused to another nerve during surgery might cause calcaneal neuroma.
ESWT: The most common non invasive method of heel spur surgery is the Electro Shock Wave Therapy (ESWT). In this method, high pressure sound waves are focused on the affected area without making any cuts or incisions. The high intensity beams perform the task of detaching the plantar fascia from the heel bone, without needing any cuts at all since the sound beams can pass through the skin. These high intensity beams induce the growth of new blood vessels in the heel region, due to which the blood supply to the affected area improves. The heel gets more oxygen and nutrients and new cells are generated at a faster speed leading to faster healing.
The whole procedure does not take more than 12 minutes
Laser surgery: Low intensity laser beams are focused on the affected area, which leads to the growth of tissues in the area at a faster rate and provides faster relief to patients.
Healing period: Non invasive surgeries do not require hospitalization and the patient can go back home after resting for three hours. Most of them can also resume normal work the following day though they are advised to give as much rest to their feet as possible, especially during the first three weeks.
The rate of success of heel spur surgery would depend upon how meticulously the patient follows his doctor’s instructions during the post recovery period. Putting on too much weight, lifting heavy loads and excessive pressure exerted on the heel may cause recurring pain.