The heel bone, which is the biggest bone in the foot, absorbs the highest amount of pressure than the rest of the foot especially during walking, standing and jumping. Like all bones, it can develop abnormalities such as when the plantar fascia – a broad band consisting of fibrous tissues running from the heel to the forefoot – pulls away from the heel bone. The result: a heel spur, which is a calcium deposit that protrudes from the heel bone and looks like a spur.
The stretching of the plantar fascia is the primary cause of the oft-painful condition. Individuals with flat feet and high arches are more likely to develop it while women are at higher risk due to their regular use of high-heeled shoes. The excessive strain on the ligaments, bones and nerves aggravate the health issues. Other causes are strains on the foot ligaments and muscles and repeated tearing of the membrane covering the heel bone. This is the reason why track and field athletes are prone to spurs because of the high frequency of running and jumping involved in their sports. Individuals who also wear poorly-fitted running shoes are at risk because of the lack of appropriate arch support.
Overweight or obese individuals are also at high risk for the development of heel spur. Their feet cannot take the extreme stress of their bodyweight and, thus, abnormalities in the ligaments, tendons and bones develop. Other risks include diabetes, frequent short bursts of exercise (i.e., sprinting), and standing for hours on your feet. Talk with your doctor about your risks for these bony protrusions since many cases are asymptomatic, which means that there are no observable symptoms so much so that the spur is only detected when x-rays of the foot for another health issue are taken.
As previously mentioned, a heel spur may or may not cause symptoms. In cases when symptoms are experienced, these are described as chronic pain like a sharp knife or large pin sticking into the bottom of the affected foot that later becomes a dull ache. The pain is pronounced when first standing up in the morning and then when walking, jogging and running. It should be emphasized that the pain comes not from the spur itself but from the soft tissue injury caused by the bony protrusion touching the surrounding area. Inflammation can develop at the juncture of the spur and the soft tissues, thus, causing the painful sensations when standing up.
Unlike other foot-related injuries, a heel spur may not respond as well as expected to rest. In fact, you will experience more pain when standing up after a full night’s sleep although it can also happen after extensive walking. This is because the plantar fascia suddenly stretches and the heel rapidly pulls, thus, worsening the abnormality in the bone.
Instead, your doctor will recommend the following treatments to lessen the pain of the spurs:
- Stretching exercises
- Physical therapy
- Strapping or taping of the feet to rest the stressed tendons and muscles
- Use of shoe inserts and/or orthotic devices as well as recommendations of shoes with good arch support
- Over-the-counter medications like ibuprofen, acetaminophen and naproxen
- Corticosteroid injections to control the inflammation
When conservative treatments fail in the relief of the painful symptoms of heel spur, then surgery may be necessary.