Heel Spur

A common source of heel pain, heel spurs (calcaneal spur) are a bony growth attached to your heel bone (calcaneus) and grows into your foot arch. These spurs are usually identified through an X-ray examination and are a type of exostosis.

What Causes a Heel Spur?

The reason behind a heel spur is chronic plantar fasciitis.

A plantar fascia is a thick fibrous band of connective tissue which originates on the bottom surface of the calcaneus i.e. heel bone and extends along the foot sole towards the toes. It acts as a passive limitation to the over-flattening of the arch. When the plantar fascia develops micro tears or becomes inflamed, it is known as plantar fasciitis.

In cases where the healing of plantar fasciitis gets delayed or when the injury persists, the body starts repairing the weak and injured soft tissue with bone. Usually, the injured fascia gets healed through fibroblastic activity. They’ll operate for at least six weeks. If the injury continues to persist beyond this, osteoblasts are recruited to the injured area. Osteoblasts form bone, and the result is calcification in the plantar fascia or at the calcaneal insertion. These bone formations are referred to as heel spurs. You can find the best and most certified Foot pain specialist in Delhi.

This type of scenario is most common with the traction type injury. The additional bone growth is known as a heel spur or calcaneal spur.

What are the Symptoms of a Heel Spur?

• Usually, people first notice early heel spur pain under their heel in the morning or after resting. If you experience this, it might be a case of heel spur.
• Furthermore, your heel pain can become worse with the first steps and enhances with activity as it warms up.
• When you touch the tender area, you may sense a tender bony lump.

How Does a Heel Spur Progress?

When the plantar fasciitis starts deteriorating; and the heel spur grows, you experience pain more often. This is when the heel spur starts progressing. 

How is a Heel Spur Diagnosed?

A physiotherapist or a sports doctor usually diagnoses Heel spurs and plantar fasciitis.

The heel spur treatment provided is based on the symptoms, history, and clinical examination.

After the heel spur or plantar fasciitis is confirmed, the foot pain specialist will check why you are susceptible to heel spurs and then make a treatment plan to reduce the chance of any future bouts.

Thereafter X-rays are conducted that show calcification or bone within the plantar fascia or at its insertion into the calcaneus. This is known as a heel spur.

The doctors use Ultrasound scans and MRI to identify any plantar fasciitis tears, inflammation or calcification in your body. Pathology tests which may include screening for HLA B27 antigen can identify spondyloarthritis that cause symptoms such as plantar fasciitis. In case you get diagnosed, connect with Boyner Clinic for the best insole for flat feet in India.

Risk Factors for Heel Spurs

You are more likely to develop plantar fasciitis and heel spurs in case you are:

• Active – If you play sports that place excessive stress on your heel bone and attached tissue, especially when you have tight calf muscles or a stiff ankle from a former ankle sprain that limits ankle movement, it may cause a heel spur.
• Overweight – If you carry around extra weight, it will increase the strain and lay more stress on your plantar fascia.
• Pregnant – Pregnant women experience weight gain and swelling, which cause their ligaments to become more relaxed, leading to mechanical problems and inflammation.
• On your feet – If you have a job that requires a lot of walking or standing on hard surfaces, it may lead to heel spurs.
• Flat Feet or High Foot Arches– A change in the foot arch can alter the shock absorption ability, stretching and straining the plantar fascia, which has to absorb the additional force.
• Middle-Aged or Older – As you age, the foot’s arch begins to sag, putting extra stress on the plantar fascia.
• Weak Foot Arch Muscles – Muscle fatigue allows your plantar fascia to overstress and cause injury.
• Arthritis – Some types of arthritis can lead to inflammation in the tendons in the foot’s bottom, which may cause plantar fasciitis.
• Diabetes – People with diabetes are also prone to plantar fasciitis. 

Heel Spur Prognosis

Pain caused by a heel spur is rarely permanent. Plantar fasciitis, the main cause of a heel spur, is reversible and can be treated successfully. As per a study, over 90 per cent of people who have plantar fasciitis or heel spurs see an improvement in their condition with physiotherapy treatment. Although the heel spur may be visible, once the inflammation adjacent to it gets settled, the pain will resolve.

However, if the plantar fasciitis or Heel Spur pain sustains after a few months of conservative treatment, the doctor may take the route of injecting your heel with steroidal anti-inflammatory medications (corticosteroid). Cortisone injections have short-term benefits; however, they may slow down your progress, which can mean that you will suffer recurrent bouts for longer. 

What is the Best Heel Spur Treatment?

The primary cause behind plantar fasciitis and heel spurs is poor foot biomechanics. Therefore, it is important to thoroughly assess and correct your foot & leg biomechanics to prevent a case of future plantar fasciitis or the development and progression of a heel spur.

The best Heel Spur pain specialist in Delhi is highly-skilled in foot control assessment and its dynamic biomechanical correction. As per your clinical assessment, the physiotherapist may ask you to practice some manual therapy techniques such as joint mobilisations to loosen stiff joints, foot-tapping, foot and lower limb strengthening exercises, soft tissue massage or release, muscle flexibility or stretches, and occasionally night splints. 

Note: The treatment of plantar fasciitis and heel spurs varies from person to person. Therefore, it is advisable that you seek the advice of your specialist for foot pain treatment in Noida.

It is recommended that you connect with a podiatrist who is an expert in the prescription of passive foot devices such as orthotics. Moreover, Foot orthosis has been shown to potentially assist plantar fasciitis and heel spurs.

The physiotherapist may advise some active foot stabilisation exercises, which are an excellent long-term solution to prevent and control heel spurs and plantar fasciitis.

As per researchers, there are 8 stages that should be covered to effectively rehabilitate plantar fasciitis and prevent its recurrence. These are:

• Early Injury Protection: Pain Relief & Anti-inflammatory Modalities
• Regain Full Range of Motion
• Restore Foot Arch Muscle Control
• Restore Normal Calf & Leg Muscle Control
• Restore Normal Foot Biomechanics
• Improve Your Running and Landing Technique
• Return to Sport or Work

Footwear Analysis

Treatment of heel spurs provided by a specialist is similar to plantar fasciitis treatment. Therefore, the physiotherapist selects the most appropriate modalities for your treatment.

Ultimately, biomechanical correction is the aim. The strengthening of Foot intrinsic muscle strengthening, including tibialis posterior, peroneus longus and stretching of the calf (gastrocnemius and soleus) are almost always required.

If you have moderate to severe biomechanical deformity, you must refer to a specialist for physiotherapy or podiatry assessment to prevent a chronic recurrence. NSAIDs and corticosteroid injection are shown to be the most effective when combined with biomechanical correction.

Mechanical treatment, which involves taping and orthoses, is shown to be more effective than either anti-inflammatories or accommodative modalities.

Plantar fascia night splints provide short-term Heel Spur pain relief. The splints overstretch the plantar fascia, which may give some short-term relief, but ultimately elongates your passive arch structures. However, the medium and long-term benefits offered make no sense of this rationale. Contrarily, permanent elongation will flatter your arches and lead to recurrent heel pain. Based on this research, Plantar Fascia night splints are NOT recommended in most instances.

Weight loss and load management influence the initiation & duration of plantar fasciitis and heel spurs. Your weight may have an impact on your plantar fascia of heel spurs, so patients with excess weight should make weight loss their priority for the best treatment for heel pain.

What Happens If You Do Nothing?

If left untreated, heel spurs can grow larger and become excessively painful. For more specific advice about your heel spur or plantar fasciitis, please contact your PhysioWorks physiotherapist.

We at Boyner Clinic have a team of world-class foot specialists that offers, contact our doctors to receive the best treatment for heel pain.