Heel spurs are one of those interesting topics that often comes up in conversation with patients. When heel pain is a problem, one of the first concerns that comes to some patients’ minds is whether it might be a spur.
Why are heel spurs so frequently brought up? It could be that the name is so easy to stand out in one’s memory. The only other times the word “spurs” ever really come up are in talks about cowboys or professional San Antonio basketball teams. And we admit it’s a lot catchier a term than something like “peripheral neuropathy.”
But what exactly is a heel spur, and what does it actually mean for you if you have one? Let’s go over a few good questions and facts when it comes to this interesting phenomenon.
So what is a heel spur, exactly?
A heel spur is a growth of calcium that causes a small, bony protrusion off the calcaneus, or heel bone. This growth tends to occur toward the bottom or underside of the heel bone, but can sometimes appear on the back as well.
A heel spur will rarely grow more than a half-inch in length, and often reaches only about a quarter-inch overall.
What causes a heel spur to form?
The growth of a heel spur can often be in response to strain or pressure in that area. In essence, the heel bone is building itself up in that spot as a means of protection against that excessive force.
This type of defensive growth is somewhat like the way a callus forms on the skin in an area of high friction. In the case of a heel spur, however, this growth can take a number of months to build up.
What types of excessive force can trigger the growth of a heel spur?
Anything that causes strain in the area of the heel bone can place enough stress on the heel bone itself to cause the formation of calcium deposits. This includes stressing of muscles or ligaments in the foot and repeated tearing of the membrane that surrounds the heel bone itself.
One particularly common cause of heel spur development is overstretching of the plantar fascia, a thick band of tissue that runs beneath the foot and is connected to the heel bone. (We will talk more about this perpetrator later.)
In general, people who are more at risk for developing heel spurs:
- Have abnormalities in foot structure (such as flat feet or high arches) or gait abnormalities that place excess pressure on certain areas of the foot.
- Are overweight.
- Wear shoes that are worn out, ill-fitting, and/or lack good support for the arches.
- Run or engage in high-impact sports on hard surfaces.
- Are older, with less natural protection around their heels and decreased overall flexibility in the feet.
- Have jobs or hobbies that involve spending most or all day on one’s feet.
- Have diabetes.
Is a heel spur is causing my heel pain?
This is the tricky part. While heel spurs are relatively common, they are not as common a cause of heel pain.
It is estimated that about one out of 10 people has heel spurs. However, of that population, only about one in 20 of them has heel pain.
In most cases, heel spurs don’t actually cause any problems to the individual who has them. In fact, many heel spurs are discovered when conducting imaging tests to look for other potential problems! They’re just hanging out there, minding their own business and causing no harm.
More often, when heel pain and heel spurs are in the same picture, it is a connected problem that is responsible for the pain.
That takes us back to the plantar fascia.
The stress that stretches the plantar fascia enough to cause heel spurs to form is often enough to inflame the plantar fascia as well—a condition known as “plantar fasciitis”. This tends to be the true cause of heel pain in most cases, even when heel spurs are visible.
Only a full examination can determine whether a heel spur is causing any trouble, or whether another problem is the true cause.
What can be done about heel spurs?
If a heel spur is not causing pain or other symptoms, then the best thing to do about it is: nothing.
However, even when a heel spur is causing problems, it can often be successfully treated via conservative methods.
Rest and icing are common effective treatments for relieving pain and any swelling caused by a spur. Additionally, physical therapy and stretching exercises may also be recommended to strengthen surrounding tissues and take less strain off the affected area.
If additional offloading of pressure and realignment is needed, we may also prescribe custom orthotics to provide the support you need. These are a very effective way to help prevent future pain and retain comfort in day-to-day life.
In some cases, MLS laser therapy can also be an effective means of pain relief and recovery.
It should be noted that the methods above are basically the same as those for treating plantar fasciitis. Regardless of the culprit, they tend to be effective.
Only in very rare situations is surgery ever considered for heel spurs; usually only if conservative treatments have failed to yield any significant results. Surgery typically involves removal of a heel spur and, when needed, repair or releasing of the plantar fascia.
Get Help for Your Heels
Regardless of the source of your heel pain or how long you have had it, something can be done to help manage your discomfort or make it fully disappear.
Southern Oregon Foot & Ankle is here to help heel pain sufferers of all ages and lifestyles. Give our Medford office a call at (541) 776-3338 or fill out our electronic contact form to request an appointment.