11.30.07
Heel Spur Pain
Heel pain is caused by plantar fascitis, which is commonly referred to as a heel spur. Plantar fascia is a broad band of fibrous tissue, which runs along the bottom surface of the foot, from the heel to the toes. Plantar fascitis is a condition in which the plantar fascia is inflamed. This can be a painful condition.
Long standing inflammation causes the deposition of calcium at the point where the plantar fascia inserts into the heel. This results in the appearance of a sharp thorn like heel spur on x-ray. The heel spur is a - symptomatic (not painful), the pain arises from the inflammation of the plantar fascia.
Symptoms of Heel Spur Pain
Symptoms include a dull ache which is felt most of the time with episodes of a sharp pain in the center of the heel or on the inside margin of the heel. Often the pain is worse when you get up in the morning and after rest and is aggravated by prolonged weight bearing & thin soled shoes.
Causes of Heel Spur Pain
- Excessive load on the foot due to obesity is a major cause of plantar fascitis. This condition is common among middle aged and over weight adults.
- A sudden increase in weight, such as pregnancy can also lead to plantar fascitis.
- A sudden increase in walking or a sporting activity can also be a contributing factor
- Tight calf muscles
- Excessive flattening of the arch on weight bearing
- Bio mechanical problems (walking abnormalities) is a major cause of plantar fascitis
- Different types of arthritis can also lead to this condition such as osteoarthritis and rheumatoid arthritis.
Treatment of Heel Spur Pain
- Orthotics- One of the most effective treatment options
- Silicone Heel Cups- Treats morning heel pain and provides excellent support and pain relief
- Plantar Fascia Night splints- Immobilize and stretch fascia, can be effective if used for several weeks
- Reusable Hot and Cold Gel Packs- Proven therapy for plantar fasciitis by alternating application of heat and cold coupled with massage works wonders to relieve pain, reduce swelling and promote healing Use ice pack in morning and heat pack in the evening
- Stretching exercises for plantar fascia and Achilles tendon
- Stretching aids- stretches the foot in the proper position to relieve heel pain
- Ultrasound and Lasers- Found to have little or no benefit
- Extra corporeal shock wave therapy (ESWT)- There are differing views about the safety and effectiveness of this treatment.
- NSAIDs (Non Steroidal Anti-Inflammatory Drugs)
- Steroid/local anesthetic injection- Not a preferred treatment option
- Surgery- ‘Open’ or endoscopic plantar fascia release. No good evidence of effectiveness, and complications include increased pain, nerve injury, facial rupture and infection.
Heel spur pain can be treated effectively by various treatment measures. It is a problem, no doubt, but can be taken care of. It is common among patients who have a history of foot pain caused by plantar fasciitis.