Heel spurs occur in at least half the people who have plantar fasciitis, a painful condition involving the thick tissue that runs between your heel bone and your toes. In the past, doctors often performed surgery to remove heel spurs, believing them to be the cause of the pain associated with plantar fasciitis. In treating plantar fasciitis now, doctors rely more on ice, arch supports, physical therapy and pain medications, and surgery is rarely performed.
This condition is a constellation of many causes; overweight, ill fitting shoes, bio-mechanical problems (mal-alignment of the heel), gout, pronation (a complex motion including outward rotation of the heel and inward rotation of the ankle) and rheumatoid arthritis are some of the causes of heel pain.
The pain caused by a calcaneal spur is not the result of the pressure of weight on the point of the spur, but results from inflammation around the tendons where they attach to the heel bone. You might expect the pain to increase as you walk on the spur, but actually it decreases. The pain is most severe when you start to walk after a rest. The nerves and capillaries adapt themselves to the situation as you walk. When you rest, the nerves and capillaries rest, also. Then, as you begin to move about again, extreme demands are made on the blood vessels and nerves, which will cause pain until they again adjust to the spur. If excessive strain has been placed on the foot the day before, the pain may also be greater. A sudden strain, as might be produced by leaping or jumping, can also increase the pain. The pain might be localized at first, but continued walking and standing will soon cause the entire heel to become tender and painful.
Because the diagnosis of heel spurs can be confused with tarsal tunnel syndrome (as described earlier), most surgeons advocate performing a tarsal tunnel release (or at least a partial tarsal tunnel release) along with the plantar fascia release. This surgery is about 80percent successful in relieving pain in the small group of patients who do not improve with conservative treatments.
Non Surgical Treatment
Treatments for bone spurs and plantar fasciitis include Stretching the calf muscles several times daily is critical in providing tension relief for the plantar fascia. Some physicians may recommend using a step to stretch, while others may encourage yoga or pushing against a wall to stretch. Icing after activity. A frozen tennis ball can provide specific relief. Rolling the tennis ball under the arch of the foot after exercise can lessen pain in the area. Taping is also recommended at times. Several manufacturers of sports tape have plantar fascia specific lines. Orthotics are a good idea for those on their feet during the day. Orthotics can provide cushioning and relief. Cortisone shots in the fascia can provide temporary anti-inflammatory relief. Losing weight is perhaps the most effective method of improving heel and foot pain. Those who are overweight are far more likely to report these syndromes.
Usually, heel spurs are curable with conservative treatment. If not, heel spurs are curable with surgery, although there is the possibility of them growing back. About 10% of those who continue to see a physician for plantar fascitis have it for more than a year. If there is limited success after approximately one year of conservative treatment, patients are often advised to have surgery.