Overview on a heel spur

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A heel spur is a usual source of heel pain which are bony growths linked to the heel bone that can radiate into the foot arch.

Generally, a heel spur is brought about by a chronic case of plantar fasciitis. The plantar fascia is a dense fibrous band of connective tissue originating from the base surface of the calcaneus and extends throughout the sole of the foot up to the toes. Once the plantar fascia ends up with micro tears or becomes sore, it is called as plantar fasciitis.

The pain or discomfort is worse during the initial steps and settles with activity as the body warms up.

Once the healing of plantar fasciitis is hindered or the injury persists, the body fixes the weakened and damaged soft tissue with bone. In most cases, the damaged fascia is healed via fibroblastic activity that lasts for at least 6 weeks. If the injury persists beyond this period, osteoblasts move into the area. These osteoblasts form bone and the outcome is bone inside the plantar fascia which are called as heel spurs.

What are the indications?

  • Initially, the heel spur can be felt beneath the heel in the morning or after resting.
  • The pain or discomfort is worse during the initial steps and settles with activity as the body warms up
  • A tender bony lump can be felt if the sore area is palpated

As plantar fasciitis continues to deteriorate and the heel spur grows, the pain might become persistent.

Management of a heel spur

Since the main cause of plantar fasciitis is poor foot biomechanics, it is essential to thoroughly assess and fix both foot and leg biomechanics to prevent future episodes or allow the formation of a heel spur.

It is important to note that active foot stabilization exercises is considered as the ideal long-term solution to prevent and manage plantar fasciitis and heel spurs.

The treatment for a heel spur is the same for plantar fasciitis. The doctor will choose the ideal approach in managing the condition. Finally, biomechanical correction is the objective. In most cases, foot intrinsic muscle strengthening and calf stretching is required.

For cases involving moderate to severe biomechanical deformity, physiotherapy or assessment by a specialist is required to prevent chronic recurrence. Non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroid injections are highly effective if used with biomechanical correction.

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