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Houston podiatrist discusses Heel SpursOne of the more common findings that I see on a foot x-ray is a #HeelSpur. Many people think that the spur is the cause of their heel pain. In most cases, that's not so. Most people live long happy pain-free lives with the heel spur. 

Many people who suffer with #HeelPain assume that they have a heel spur. Some do and some don't. But even if they have a heel spur, it's not necessarily the cause of the pain. The confusion is understandable. Heel pain could be named a few different ways. Commonly heel pain is due to plantar fasciitis. It's also referred to as heel spur syndrome that implies that the heel spur is responsible for the heel pain. A heel spur is a bone spur attached to the calcaneus - the heel bone. It is also an attachment to the plantar fascia ligament. When you walk, the ligament pulls on the heel bone, when there's excessive tension on the heel bone, it leads down new bone in the direction of the tension and forms a heel spur. Here's the thing. The heel generally has a thick fat pad. So even if a heel spur forms, it's usually well cushioned. Heel pain is commonly due to the inflammation of the plantar fascia ligament, where it attaches to the heel bone. Or in this case, the heel spur. 

This makes it seem like the spurs causing the pain. If that were the case, then the only choice for the pain to resolve would be to remove the heel spur. In truth, surgery is only necessary about 5% of the time. Plantar fasciitis is usually well controlled with conservative measures. These include anti-inflammatory medication, cortisone injections, stretching, icing, and custom orthotics. There is a time when a heel spur can directly cause pain. It happens when the fat pad in the heel wears away. In this case, the pressure from the heel spur is directly causing the pain. Since there's no fat padding to cushion it. When this happens, my first pass at treatment is very conservative. I recommend a thick gel pad to be placed in the shoes under the heel. Think of gel as artificial fat. This is often sufficient to solve the pain. Another treatment that's been effective is the injection of processed adipose tissue, essentially injecting fat tissue. 

In the heel, I use a product called #Leneva to accomplish this. The procedure is done in the office. After I numb the site where I'm going to inject the fat tissue, I introduce a needle to spread it uniformly just beneath the skin. The results have been astounding. Of course, there are times where the only way to relieve the pain is to surgically remove the heel spur. This procedure is done in an outpatient surgery center. I make an incision on the side of the heel. I detach the plantar fascia ligament and remove the heel spur. This removes the pressure from the heel spur and eliminates the pain.