Bone spurs usually form around joints that have arthritis, in the vertebrae of the spine, and on the heel. When they form on the heel, they may form on the back of the heel but usually form on the
bottom of the heel. Of course, this is where all of the body weight comes down with each step. Spurs on the bottom of the heel are usually most painful the first few steps out of bed each morning.
The pain may lessen somewhat after walking for a few minutes, but may be intense again after sitting for a half hour or so, such as after lunch. The pain usually gets worse throughout the day as you
are up on your feet more. Often the pain feels like a nail being driven through the heel into the ankle and leg.
Heel Spurs develop when the plantar fascia is excessively and repetitively pulled away from the heel bone. In many cases, a heel spur can develop along with plantar fasciitis, but can also occur by
itself. Heel spurs often develop in middle-aged patients, but can also occur in younger people as well. Athletes are especially prone to heel spur due to the regular stress on their heels.
Heel spurs often do not show any symptoms. If you have intermittent or chronic pain when you walk, run or jog, it may be heel spur. There will be inflammation the point where spur formation happens.
The pain is caused by soft tissue injury in the heel. Patients often describe the pain as a pin or knife sticking to the heel. The pain is more specially in the morning when the patient stands up for
the first time.
Diagnosis is made using a few different technologies. X-rays are often used first to ensure there is no fracture or tumor in the region. Then ultrasound is used to check the fascia itself to make
sure there is no tear and check the level of scar tissue and damage. Neurosensory testing, a non-painful nerve test, can be used to make sure there is not a local nerve problem if the pain is thought
to be nerve related. It is important to remember that one can have a very large heel spur and no plantar fasciitis issues or pain at all, or one can have a great deal of pain and virtually no spur at
Non Surgical Treatment
In some cases, heel spur pain may not be resolved through conservative treatment options. In those cases, cortisone injections may be used to reduce inflammation associated with the condition,
helping to reduce discomfort. However, treatment options such as these must be discussed in detail with your physician, since more serious forms of treatment could yield negative side effects, such
as atrophy of the heel's fat pad, or the rupture of the plantar fascia ligament. Although such side effects are rare, they are potential problems that could deliver added heel pain.
Have surgery if no other treatments work. Before performing surgery, doctors usually give home treatments and improved footwear about a year to work. When nothing else eases the pain, here's what you
need to know about surgical options. Instep plantar fasciotomy. Doctors remove part of the plantar fascia to ease pressure on the nerves in your foot. Endoscopy. This surgery performs the same
function as an instep plantar fasciotomy but uses smaller incisions so that you'll heal faster. However, endoscopy has a higher rate of nerve damage, so consider this before you opt for this option.
Be prepared to wear a below-the-knee walking cast to ease the pain of surgery and to speed the healing process. These casts, or "boots," usually work better than crutches to speed up your recovery
A variety of steps can be taken to avoid heel pain and accompanying afflictions. Wear shoes that fit well-front, back, and sides-and have shock-absorbent soles, rigid shanks, and supportive heel
counters. Wear the proper shoes for each activity. Do not wear shoes with excessive wear on heels or soles. Prepare properly before exercising. Warm up and do stretching exercises before and after
running. Pace yourself when you participate in athletic activities. Don't underestimate your body's need for rest and good nutrition. If obese, lose weight.