All about treating heel spur
Heel spur (also called plantar fasciitis, bone spur or calcaneal spur) is a very nasty foot injury that can be very hard to get rid of. Fortunately there are many treatments, some of which have a high success-rate (like stretching or the Strassburg Sock). Heel-spur.info attempts to discuss every available treatment. Some of these treatments can be applied at home, for others you should seek the assistance of a podiatrist or chiropodist.
We describe a total of 22 different treatments here, divided into 3 sections: Self-aid, Therapist and Alternative. Hopefully one of these will get you back on your feet again!
When you suffer from plantar fasciitis, the heel hurts. Previously, it was thought that heel spur is an inflammation under the heel close to the attachment of the plantar fascia, which runs from the heel to the forefoot. The current opinion is that the pain in the heel is caused by damage to the collagen fibers of the fascia.
Often some calcification occurs (creating a bone spur), which can be seen on X-ray. Because the X-ray is taken from the side this calcification often looks like a real spur, while actually this is much less so than shown on the X-ray, as the plantar fascia is quite broad here.
This 'bone spur' does not necessarily cause heel pain. Almost 30% of all people have these spurs, while only a limited number of people has complaints. It even happens that people have heel pain without the presence of a spur. The actual problem that causes pain is the inflammation.
In short: most people with heel pain suffer from plantar fasciitis, which is often (though not necessarily) accompanied by a calcaneal spur. As the complaints will be the same in both cases (as is the treatment), from now on, we will only refer to heel spur, as this is the most common term for this injury.
This X-ray image shows a clearly visible spur. This actually is quite an extreme example. Most patients have a much less prominent spur. In some patients, no spur is even found, while people without heel pain often do have a spur.
Basically heel spur is a stress injury similar to a tennis elbow, caused by too much tension or weight on the tendon, which creates a pulling force where the tendon is attached to the heel. Actual overload like running or jumping can cause this.
Also wearing wrong shoes is a major factor contributing to heel spur and plantar fasciitis. Especially in cheap shoes often not enough care is being put in creating a good footbed, causing an incorrect stance of the feet and body.
There are however quite a few other reasons why you could develop a heel spur injury. To sum up these and some other causes:
- Overload through sports, especially sports involving running long distances, jumping, or sports where sudden movements can occurr. Sports that are potentialy more
- Mountain walking (Walking hill-up causes a lot of stretch and stress on the fascia)
- Inadequate footwear. Good shoes offer support for the shoes, while bad shoes can cause an unnatural strain to the fascia.
- No cushioning in the shoes. Especially if the heel fat pad cushion of the feet is thin (often with elderly people), your shoes should offer this cushioning. Also for runners this is important.
- Stiff soles, preventing a natural form of walking
- Overweight causes massive strain on the heel.
- Short calf muscles: If the muscles in the calf are short, they often tend to pull on the plantar fascia as well, as these muscles and tendons are inter-connected.
- Standing still a lot
- Flat or hollow feet or other abnormalities in the feet.
- Heel cushion atrophy (not enough cushioning tissue beneath the heel, often found in elderly people)
There may even be more causes to point out, but these are the major ones.
Heel spur patients will often suffer from pain under the foot, especially under the foreside of the heel. They often have a sore heel. Symptoms reported include the following:
- Irritation beneath the heel, especially in the morning or after longer periods of inactivity. After some walking around or warming up, the pain usually eases a bit. The problem is that nerves and blood vessels also rest, and a sudden switch to walking causes a painful stress reaction. This stress subdues after some warming-up. This is especially the case for early heel spur sufferers. More severe cases will continue to feel the pain, which can actually even worsen as a result off walking around.
- Painful standing still
- Stifness or tension in the fascia that runs along the bottom of the foot.. People in occupations that require to stand still frequently and for prolonged periods of time will often develop severe heel pain. This is why heelspur is sometimes referred to as "Policeman's heel"...
- The fascia feels distinctly taut and tense, which is also a stress reaction.
- Pain felt while driving a car, caused by the unnatural position of the foot (cruise control helps!).
- Often the heel pain is hard to localize, with the whole underfoot feeling sore, or also more clearly concentrating in the heel. The pain can also vary from day to day.
Try to pay attention to all these symptoms, and respond accordingly. The longer the injury lasts, the longer it takes to get rid of it!
Given all the possible treatments for heel spur you may find it hard to choose a particular therapy to follow. This website provides some guidance here, by giving an overview of all known treatments and indicating both the pro's and cons. Some of these methods can be applied quite easily and are worth trying out first, before turning to some of the more drastic measures.
Especially in the early stages of heelspur, there are some very simple measures that often help. Of course it is always wise to consult your doctor, but here are some easy treatments:
Check your shoes, and replace them if necessary; bad shoes are frequently to blaim for the injury. In addition to that, there are some fairly good standard inlay soles on the market that encourage and support a good stance.
You should also check your stance when standing and walking and, if applicable, you should try to lose some weight. For the pain you could try some painkillers, but remember that this just relieves the pain itself, not the heelspur itself.
Still suffering? Stretching your muscles, especially foot soles and calves is very useful, optionally combined with some workouts for your leg muscles. Also the Strassburg sock or night splint can support the healing process, as well as cooling the injury with ice.
If none of these measures work, then you should really visit a good doctor, or a physio-therapist or a podiatrist.
A podiatrist will usually offer advice on custom inlay soles, depending on the stance of your feet. A physiotherapist will usually work on strengthening your leg muscles, apply massage (sometimes friction massage), tape the foot, or treat you with shockwave therapy. Shockwave therapy is increasingly applied as one of the standard methods to treat heelspur, and often with considerable success.
Still no improvement? Then there are some drastic methods you could try, like surgery or injections. These methods are sometimes successful, but are also known to sometimes achieve the opposite effect, in other words aggravating the condition.
Finally, some alternative methods are discussed here::
- triggerpoint massage
- And there are even more options, but these are just too specific or controversial to be discussed here. You can do some further on-line research to see whether they might be worth pursuing; see for example: osteopathy, homeopathy, ABC therapy, etc.