Heel Spur: Typical Causes, Symptoms & Treatment Advice
Are you suffering foot and heel pain? If so, you may be experiencing pain that is associated with a heel spur. Heel spurs are a bony growth on the calcaneus (heel bone) which may protrude into the arch of the foot towards the plantar fascia. Your plantar fascia is a thick fibrous band of soft tissue which extends between the calcaneus and toes and acts to absorb stress that is placed upon the foot during activity as well as maintain the arch of the foot. When the plantar fascia experienced damage or injury your body automatically attempts to heal it. During this process there is an increase in fibroblast and osteoblast activity. This activity may lead to the development of bony spurs on the heel resulting in a heel spur.
SIGNS & SYMPTOMS OF A HEEL SPUR
If you’ve never experienced heel spur pain you may be wondering what are the classic signs & symptoms of injury:
- Commonly no symptoms are present until heel spur formation has occured
- Pain may be noted upon waking or during prolonged periods of walking, running, jumping and landing activities
- Tenderness is noted when the heel is palpated
HEEL SPUR RISK FACTORS
- Activity: Particular activities and sports place excessive stress and strain upon the foot and heel complex
- Overweight: Carrying additional kilograms can irritate the foot and heel and contribute to the development of heel spurs
- Pregnancy: While pregnancy is a fantastic time in a woman’s life, it is common to experience swelling, weight gain and changes in your gait pattern due to changes in your centre of gravity
- Occupation: Jobs that require you to spend excessive periods of time on your feet or individuals who work on hard surfaces
- Foot abnormalities: Changes in foot alignment, arch height and more may contribute to changes in the plantar fascia
- Footwear: It is always important to choose footwear that provides adequate arch for foot support
HOW IS A HEEL SPUR DIAGNOSED?
Heel spurs and plantar fasciitis usually co-exist. However, your treating therapist will perform a comprehensive clinical examination of your feet in order to determine your exact problem. To commence your physical examination you will be asked various questions in order to guide your practitioners examination. These questions may include:
- How long have you been experiencing this pain?
- Do you notice the presence of tingling or numbness?
- Can you identify any activities which particularly aggravate the problem?
- Can you identify any activities which reduce the problem?
- Have your experienced heel spur pain before? If so, what treatment was administered and was it helpful?
Following this discussion:
- Your practitioner will palpate your feet and observe for any tenderness or skin changes
- Perform a variety of orthopaedic and neurological tests if required
- Arrive at an accurate diagnosis and prescribe a specific management plan to assist your recovery
HOW ARE HEEL SPURS TREATED?
There are numerous phases of treatment which may include:
- Early injury protection, pain relief and anti-inflammatory strategies
- Reduce foot tissue tightness and spasm through soft tissue therapy and associated modalities
- Improve foot and ankle biomechanics
- Analysis of footwear and gait pattern
- Return to normal sport and activities
WHAT DOES THE RESEARCH TELL US?
- While sample size constraints were noted by the author, conservative management including Chiropractic foot and ankle manipulation, stretching and orthotics resulted in clinically significant improvements in heel pain. Dimou, E. (2004). A randomized, controlled trial (with blinded observer) of Chiropractic manipulation and Achilles stretching vs. Orthotics for the treatment of plantar fasciitis. Journal of the American Chiropractic Association, 41(9); 32 – 42.
- Low energy Shockwave treatment appears to form an effective part of conservative Chiropractic management for disorders involving the foot, ankle & heel. This may in turn prevent individuals requiring surgery for heel spurs and associated foot abnormalities. Rompe, J. (2002). Evaluation of low energy extracorporeal shockwave application for the treatment of chronic plantar fasciitis. The Journal of Bone & Joint Surgery, 84(3); 335 – 341.