A heel spur is a very common finding when I take x-rays in my Houston podiatry office. Most of the time, it’s a finding that doesn’t have anything to do with the pain you’re feeling. In fact, a heel spur may be painless. Sometimes, however, it can be the cause of your heel pain. This is known as Heel Spur Syndrome.
A heel spur can also be a symptom of another condition. People with plantar fasciitis commonly has a heel spur on the bottom of the heel. Achilles tendonitis often has an associated heel spur on the back of the heel. I’ll talk more about those later on.
What Causes a Heel Spur?
A heel spur is when a calcium deposit forms a bone spur that builds on the heel bone. It occurs because of tension on the bone caused by soft tissue structures that are attached to the bone. A heel spur on the bottom of the heel is because of the tension of the attached plantar fascia ligament. A bone spur on the back of the heel is caused by the tension of the Achilles tendon.
It takes many months for a bone spur to develop. Constant tension of the soft tissue on the bone causes your body to form calcium deposits. These calcium deposits build up to form a heel spur.
Aside from plantar fasciitis and Achilles tendon stress, heel spurs may be caused by:
- Trauma to the heel
- Having flat feet
- Having high arched feet
- Athletics involving running and jumping
- Being overweight
- Wearing shoes with little or no support
- Getting older
- Inflammatory arthritis
What Does a Heel Spur Feel Like?
You may think that a heel spur is the cause of the pain you are feeling on the bottom of your heel. That’s not usually the case. That pain is usually due to inflammation of the plantar fascia ligament. The heel spur shows that there has been stress there for a long period of time.
It is possible to have pain from the heel spur itself. The pain usually occurs in older adults because the natural fat pad on the bottom of the heel wears away. That leads to you walking directly on the heel spur.
When you have pain from heel spurs you’ll feel:
- Sharp, stabbing pain on the bottom of your heel
- Pain with your first few steps out of bed in the morning
- Pain when you stand after sitting for a period of time
- Pain in the evening
- Pain after you run or exercise
How is Heel Spur Syndrome Diagnosed
When you come into the office with heel pain, I will always take an x-ray. An x-ray will show a heel spur, both on the bottom or the back of the heel. I may also check your heel with an ultrasound machine so I can look at the ligaments and tendons. This will help me see if they are inflamed or if it the heel spur causing your pain.
I may order other imaging studies, such as an MRI, if your pain doesn’t get better with treatment.
Heel Spur Treatments
Heel Spur Inserts
In some cases, the heel spur is the cause of your pain on the bottom of your heel. It is usually because of the natural fat pad on the bottom of your heel. Over time, it can wear down. This will cause you to feel the heel spur when you walk.
In these cases, the answer is to use a gel heel insert. This insert will sit under your heel and act as an artificial fat pad. The gel will cushion your heel spur. This will stop the impact on the heel spur when you walk and will reduce pain.
Custom Orthotics for Heel Spurs
Your heel spur may be associated with plantar fasciitis or Achilles tendonitis. In these cases, you would benefit from using a custom orthotic. A custom orthotic is a specialized insole designed especially for you. The goal of a custom orthotic is to provide efficiency and stability to your feet. It will reduce the tension caused by the plantar fascia ligament and the Achilles tendon. That’s what’s causing the heel spur in the first place. In fact, using an orthotic can help to prevent heel spurs from growing larger.
When I design a custom orthotic for a patient with a heel spur, I add a pad on the heel. The pad will keep the pressure off of the heel spur. This is the best of both worlds. You’ll get the support you need to treat the plantar fasciitis or Achilles tendonitis. You’ll also get the cushioning you need to keep the heel spur from hurting you.
Treatment for Heel Spur Pain
When your heel spur is causing pain, it is due to inflammation of the ligament attaching to it. It is helpful to use anti-inflammatory medications to treat this pain. This can be an oral medication that is prescribed for you.
If the pain is severe, I may recommend a cortisone injection to treat your heel spur pain. This injection drops the anti-inflammatory medications right where the pain is. It is often the quickest way to reduce pain.
Heel Spur Surgery
Surgery to treat a heel spur is uncommon. In fact, less than 5% of cases involving a heel spur end up with surgery. If you have a heel spur, chances are you’ll get better with conservative care. There are times when surgery is the only remaining solution.
Surgery for a heel spur involves a small incision on the side of the foot. I release the plantar fascia ligament from the heel spur. I then remove the heel spur and smooth the remaining bone. You’re able to walk in a surgical shoe after the surgery. You’ll have a dressing on your foot and wearing the surgical shoe for about 3 weeks after the surgery.
Once you recover from the surgery, you will need to wear a custom orthotic. This is because of the weakness that is created by releasing the plantar fascia. A custom orthotic will allow for stability. It will help prevent future problems as well.
Don't Wait To Get Your Heel Spur Pain Evaluated
You can live a long, healthy, pain-free life with a heel spur. If a heel spur does cause pain, don’t wait to get it checked. This will get you out of pain quickly. Contact my Houston podiatry office to schedule an immediate visit. I will evaluate your heel pain and solve it once and for all.