A common cause of heel pain is the heel spur, a bony growth on the underside of the heel bone. The spur, visible by X-ray, appears as a protrusion that can extend forward as much as half an inch.
When there is no indication of bone enlargement, the condition is sometimes referred to as "heel spur syndrome." Heel spurs result from strain on the muscles and ligaments of the foot, by stretching
of the long band of tissue that connects the heel and the ball of the foot, and by repeated tearing away of the lining or membrane that covers the heel bone. These conditions may result from
biomechanical imbalance, running or jogging, improperly fitted or excessively worn shoes, or obesity.
Early signs of heel pain are usually due to plantar fasciitis, the inflammation of the plantar fascia. It is probably the most common cause of heel pain seen by the podiatrist. It is seen in all
groups of people; runners, athletes, weekend warriors, people who have jobs requiring a fair amount of standing, walking, or lifting, and those who have recently gained weight. The pain most often
manifests itself after periods of non-weight bearing when the plantar fascia is given a chance to rest, so your first steps cause a sudden strain to the tissue. Pain is most common with the first
steps in the morning and after periods of rest. Fortunately, upwards of 80 percent of those treated early do remarkably well with conservative therapy.
Some symptoms at the beginning of this condition include pain and swelling, and discomfort when pushing off with the toes during walking. This movement of the foot stretches the fascia that is
already irritated and inflamed. If this condition is not treated, pain will be noticed in the heel when a heel spur develops in response to the stress. This is a common condition among athletes and
others who run and jump a significant amount.
Sharp pain localized to the heel may be all a doctor needs to understand in order to diagnose the presence of heel spurs. However, you may also be sent to a radiologist for X-rays to confirm the
presence of heel spurs.
Non Surgical Treatment
Bone spurs rarely require treatment unless they are causing frequent pain or damaging other tissues. Because heel spurs and plantar fasciitis are so closely related, they are usually treated the same
way. Symptomatic treatment involves rest, especially from the activity that is contributing to the condition and making symptoms worse (although this may not be easy to discover, as problems can
manifest several hours or days after the harmful activity has occurred). If you identify the offending activity, ice is recommended immediately following it. Stretching of the calf muscles after a
short warm up is also a good idea and can be helpful. Stretching exercises that gently lengthen the calm muscle will relax the tissue surrounding the heel and should be done several times a day,
especially in the morning and after prolonged sitting.
Sometimes bone spurs can be surgically removed or an operation to loosen the fascia, called a plantar fascia release can be performed. This surgery is about 80 percent effective in the small group of
individuals who do not have relief with conservative treatment, but symptoms may return if preventative measures (wearing proper footwear, shoe inserts, stretching, etc) are not maintained.