The most common cause of heel pain, which is a frequently encountered disease in orthopedics outpatient clinic, is the discomfort known as heel spur.
What is a heel spur?
What causes heel spurs?
Who has heel spurs?
Which diseases are associated with heel spurs?
What are the symptoms of heel spurs?
How to recognize heel spurs?
How to treat heel spurs?
Is there a heel spur medicine / medication?
Is there heel spur surgery?
What are the exercises for heel spurs?
What is a Heel Spur?
A heel spur is a bone-like deposit that forms between the heel bone and the arch of the foot (ball of the foot) and is usually seen as a calcium deposit.
It usually starts in the middle and front of the heel, then affects other parts of the heel and can cause pain in the entire foot.
This spike-shaped build-up is usually caused by prolonged stretching of muscle and connective tissue.
Causes that increase the stress;
– Walking barefoot on hard surfaces,
– Standing or running for long periods of time,
– Repetitive pressure increases (such as jumping… etc.)
Signs of inflammation such as pain, swelling and increased temperature can be seen in the anterior part of the heel.
X-rays may show a bone spur about 1 cm in the shape of a rose thorn on the heel. However, there may not be bone protrusion in every X-ray. This condition is called “heel spur syndrome”.
The heel spur may develop due to an underlying disease or it may occur on its own. It can be located in front of the heel just below the arch of the foot or behind the heel.
The heel spur that develops behind the heel is usually seen at the attachment site of the Achilles tendon (the thickest fiber of the body). In this inflammatory condition known as Achilles tendonitis, pain occurs in the back of the foot by stretching the front of the foot.
Heel spurs on the front of the heel are often associated with plantar fasciitis. Plantar fasciitis is a painful inflammation of the fibrous connective tissue called the plantar fascia, which runs under the foot and connects the heel bone to the toes.
What Causes Heel Spurs?
The structures around the heel (soft tissues, muscles and plantar fascia) accumulate calcium as a result of a long-term inflammatory process initiated by repeated injuries.
The plantar fascia is a bridge-shaped strip of fiber that connects the heel bone to the toes.
Heel spurs are particularly common among athletes who do long running and jumping.
Who has heel spurs?
Female gender
Advancing age
Weight gain and/or obesity,
Brisk walking or jogging, especially on hard surfaces,
Gait abnormalities,
Mismatched or poorly worn shoes,
Foot arch problems (flatfoot, hollow arches… etc.)
Coexistence of plantar fasciitis condition,
Trauma,
Diabetes
Long standing work,
Excessive physical activity, often for short periods of time.
Which diseases are associated with heel spurs?
Plantar fasciitis
Achilles tendonitis
Reactive arthritis (Reiter’s disease)
Ankylosing spondylitis
Diffuse idiopathic skeletal hyperostosis
What are the symptoms of heel spurs?
The most common complaint is intermittent or prolonged pain, as the heel spur is not the cause of any complaint. Pain may occur especially when walking or running. In general, the cause of the pain is not due to the heel spur, but to soft tissue injury around the spur.
Many people describe it as a stabbing or pinprick pain in the soles of their feet when they first stand up in the morning (first-step pain). The pain then turns into an uncomfortable ache. The sharp pain usually occurs when you first stand up after sitting for a long time.
Other symptoms seen in heel spurs are;
Redness and swelling in front of the heel,
Increased temperature in and around the affected area,
Small, hard protrusion under the heel, visible to the naked eye,
Tenderness under the heel that makes it difficult to walk barefoot
How to recognize a heel spur?
The foot is X-rayed and the X-ray shows a bone spur. Some people have no symptoms at all and the heel spur is only detected incidentally on X-rays taken for another reason.
How to treat heel spurs?The aim of treatment is to reduce pressure on the foot (especially in the heel area), control pain and inflammation, promote tissue healing and increase the elasticity of the soft tissues.
Rest: By reducing the pressure applied to the foot, it can be effective in reducing the inflammatory condition in the affected area and the associated pain and swelling.
Cold application: It can help reduce pain and swelling by suppressing inflammation.
Use of orthotics: Ring-shaped insoles, silicone supports are used to relieve pressure on the heel. Personalized insoles.
Rest splint applied at night
Stretching exercises (most important)
Physical therapy
Wearing sneakers: Used to relieve pressure on the foot.
Painkillers.
ESWT (extracorporeal shock wave therapy): High-energy sound waves are used to stimulate healing of the damage.
Prolotherapy: A sugary serum is injected into the damaged area to stimulate the healing process.
PRP: Platelet-rich plasma obtained from the person’s own blood is injected to accelerate tissue healing.
Steroid (cortisone) injections: Reduces swelling and pain in the affected area.
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Is there any medicine(s) for heel spurs?
There is no specific medication developed for heel spurs. The drugs used in the treatment try to suppress the inflammation and accelerate tissue healing. Drugs used for this purpose;
Painkillers and anti-inflammatory drugs
Creams, ointments and gels
Supplements to help tissue healing (such as collagen)
Is there surgery for heel spurs?
In rare cases, surgery may be needed for heel spur pain. Many patients benefit from non-operative treatments.
The aim of the surgery is not to remove the spur. It is a simple intervention to reduce the tension of the arch of the foot to reduce the tension that causes pain (called plantar fascia release).
What are the exercises for heel spurs?
Shortening of the muscles and ligaments in the foot and calf causes pain due to chronic stretching. Stretching exercises are used to lengthen the fibers and reduce tension.
Some exercises that can be done for this purpose:
With more than 20 years of experience, we serve our patients in our polyclinic. You can contact us for all your heel spur problems. For this, you can contact us at any time through the channels on our web page.
