What are the symptoms of heel spurs / plantar fasciitis? First of all of course this is the typical pain under the heel. Most patients especially suffer from this after they get up from bed or after longer periods of inactivity when the pain feels really sharp. Then the pain often eases out a bit, becoming more dull and remaining all day. Increased activity may cause the pain to become worse again. Especially if your profession forces you to stand on your feet a lot, this can be very inconvenient. There are many known cases where people have to look for other work as theyy simply can'stand the pain anymore.
Symptoms really differ from patient to patient, so let's sum up all possible symptoms:
Most common heel spur symptoms
- Pain under the heel. Although usually present all day, it's usually worse after sleep or rest. Warming up a little often helps a little. This is because the nerves and blood vessels get stressed after the change from rest to activity. When you have to stand or walk for longer periods pain may increase again, sometimes becoming really unbearable
- Pain when walking
- Painful standing still. Especially if you work in a shop or with other activities forcing you to stand up for longer period's, the pain can become really bad. This is also why heel pain is sometimes referred to as "Policeman's heel"...
- A stiff or tense feeling in the fascia, the tendon under the foot. Also the achilles tendon can become irritated sometimes. This is a stress reaction of the tendons
- Heel pain when driving a car. The unnatural stance of the foot while driving a car often stresses the fascia. The best solution for this is to use your cruise control
- Often the pain is not located to just under the heel. it may radiate to the side of the foot. Also the pain may differ over time
Heel spur on X-ray and echo
If a doctor closely examines the heel, he may often find a small spur under the heel, hence the name. In the photo below, you see it in the circle:
The funny thing is, though, that not all patients with heel pain suffer have a bony spur, while there are also many people that have a spur without any pain whatsoever. Actually, the spur looks like a sharp object, but actually what you see is calcium deposit in the fascia attachment to the heel. As the fascia is quite a broad band, from the side the calciam deposits sem to form like a dagger, but this is not actually the case.
The real problem is the inflammation that often occurs. To correctly diagnose this, you need to check the area with other techniques, like radiography, echo's or MRI. These techniques are better capable of checking the tissues in the foot as opposed to the bony area's that an X-ray looks for. Esecially a thickened attachent of the fascia is a clear symptom of an inflammation.
Certain groups of people have more risk of getting heel spurs then others. These are the main ones:
- Older people: Most patients turn out to be between 40 and 60 years old.
- Women: For some reason they seem to have a higher chance of getting heel pains then man, something which is also observed with hallux valgus (bunions). It is not quite clear why this is the case, though the type of shoes they wear might sometimes contribute.
- Sporters and athletes: They often stress their foot more, increasing the risk of injury.
- Standing professions: Similarly, people that have to stand up long have a higher chance of getting heel spur
- Children: They sometimes have a typical form of heel pain called Sever Schinz. Luckily they usually grow over it.