I Think I Have A Heel Spur. What Should I Do?
Heel spurs have long been attributed to as a leading cause of heel pain. But what are heel spurs and how are they treated? There’s a lot of misunderstanding around heel spurs out there, so today our podiatrists are clarifying what you need to know if you’ve been diagnosed with a heel spur, one has been found on your foot x-ray, or you have a strong feeling that you may have a heel spur based on your heel pain symptoms.
First: What Is A Heel Spur?
Technically speaking, a heel spur is a small outgrowth of bone from the bottom of the heel area, medically known as an osteophyte. It often appears like a small spike (spicule) that hooks up towards the midfoot, following the same path as a soft tissue on the bottom of the heel called the plantar fascia. Heel spurs also tend to start from the same area that the plantar fascia originates from. This means that when discussing the cause of a person’s heel pain, heel spurs and plantar fasciitis can easily get mixed up.
What Causes A Heel Spur?
Heel spurs develop in response to damage and strain to the soft tissues that insert at the bottom of the heel. Gradually, over many months, calcium deposits build up to form the spur. This strain can be from excess pressure on the heel bone, abnormal foot biomechanics, wearing worn-out or unsupportive footwear, prolonged periods standing or walking on hard surfaces, as a result of inflammatory arthritis, and more. The development of a heel spur may also be encouraged by other problems like the breakdown of the fat pad of the heel.
What’s The Difference Between Heel Spurs And Plantar Fasciitis?
While a heel spur is a bony outgrowth at the bottom of the heel, plantar fasciitis is the inflammation of the plantar fascia tissue. The plantar fascia is a thick ligamentous band that runs from the bottom of the heel to fan out across your arch and insert into your toes. When the plantar fascia is damaged, plantar fasciitis can develop. Looking at the two conditions, they are very different by nature - a damaged connective tissue, versus a bony protrusion.
So How Do I Know What’s Causing My Heel Pain?
Truthfully, nine times out of ten, plantar fasciitis is the true cause. Think of it this way: almost all of the cases of heel pain we see and manage respond to treatment, without the bony spur ever being ‘removed’ or ‘broken down’. This tells us that it’s the damaged soft tissue that is able to heal and repair to relieve the painful symptoms you may be experiencing, and not the bony spur. Clinical evidence supports this notion, finding that a “high rate of spurs can also be found in painless feet”.[1] This means that many people may currently be living with a heel spur regardless of whether or not they experience any symptoms of heel pain. We are often reminded of this as podiatrists when we see heel spurs on x-rays we have requested for our patients, even if we are actually examining a different (unrelated) problem and the patient does not have any heel pain at present. With this said, heel spurs can cause heel pain in some cases, which is what we may consider if we see certain symptoms during your assessment or if we don’t achieve the expected response to our proven heel pain treatments.
So What Should I Do If I’m Experiencing Heel Pain?
The first thing is to book in for an assessment with your podiatrist so they can find out what’s really causing your heel pain. While plantar fasciitis is a common cause, and heel spurs is a commonly perceived cause, there are actually a wide range of causes of heel pain at the bottom of the heel, including:[2]
- Heel raises - if your heel pain is also linked to your Achilles tendon, then slipping these heel raises inside of your shoes can go a long way to helping relieve some of the strain away from the Achilles tendon and give you some comfort - at least for the back portion of the heel. When we’re dealing with complex heel pain, every bit of relief helps!
- Orthopaedic felt - as podiatrists we absolutely love this felt because it’s so versatile and helpful with also sorts of aches or pains. If your heel pain is located on a very specific spot on the bottom of your foot, you can add the pad to your foot with a ‘cut out’ of the painful area. It’s also fantastic for cushioning, shock absorption and offloading, not just for your heel but the rest of the foot, too.
- The fasciitis fighter helps you really hone in those foot exercises to best support your plantar fascia to heal, repair, strengthen and optimise its flexibility and function. It’s also a great reminder to do your exercises daily so you can keep your heel pain gone for the long-term.
- These Dr Comfort socks are the cream of the crop when it comes to socks that put your foot health and comfort first, helping you to feel most comfortable on your feet throughout the day.
Get started on your way to being free of heel pain by booking your appointment with our experienced podiatry team. You can call us on 03 355 9481, book online here, or email our reception team at reception@merivalepodiatry.co.nz
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10387834/