Heel Spur

Heel Spur

What is a Heel Spur?

Heel spur or calcaneal spur is a condition associated with heel pain caused by an outgrowth of bone that extends from the heel bone (calcaneus). However, it is important to know that heel spurs usually do not cause heel pain. The heel pain from patients with heel spurs is typically due to the presence of underlying plantar fasciitis or Achilles tendinitis.

There are 2 areas of the heel bone where spurs are commonly found – plantar (bottom of the heel) and posterior (back of the heel).

 

Causes of Heel Spur

Heel spur formation is considered a process of adapting to stress. The are 2 soft tissue structures attached to the heel bone (calcaneus), Achilles tendon and plantar fascia. When we stand, walk or run, the Achilles tendon and plantar fascia will stretch and create traction (pulling) on the attachment point of the heel bone. This repetitive stress on the heel bone triggers an inflammatory response and causes calcium to be deposited at the attachment, forming a heel spur over time.

Risk Factors of Heel Spur

Risk factors of heel spur include:

  • Obesity or high BMI
  • Flat feet (pes planus) or high arch feet (pes cavus)
  • Tight calf muscle (triceps surae)
  • Tight plantar fascia band
  • Underlying systemic conditions (e.g ankylosing spondylitis, rheumatoid arthritis)

Heel Spur Treatment

The treatment for heel spurs involves addressing factors to reduce traction from the Achilles tendon or plantar fascia on the heel bone. Directed treatment will be necessary if the patient presents with pain caused by plantar fasciitis or Achilles tendinitis.

Treatment options for heel spur include:

  • Avoid barefoot walking
  • Change to cushioning footwear
  • Customised foot orthoses to reduce tendon and fascia stress
  • Calf and plantar fascia stretch

Surgical removal of a heel spur is only required if it is the primary cause of heel pain and the above options do not provide symptom relief.

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