Overview
The calcaneus is the largest bone in the foot. Pain in the heel region can sometimes be related to Plantar Fasciitis, inflammation of the plantar fascia ligament in the heel area. A heel spur is a hook of bone that forms on the calcaneus where the plantar fascia attaches. Heel spurs can be identified with an X-ray. A heel spur can occur with or without Plantar Fasciitis.
Causes
The calcaneal spur is seen most often in persons over the age of 40. The condition can also be associated with osteoarthritis, rheumatoid arthritis, poor circulation of the blood and other degenerative diseases. Men and women are equally likely to have them.
Symptoms
Heel spurs can be quite painful, but can just as likely occur with no symptoms at all. Plantar fasciitis is a contributing condition to heel spurs. The cause of the pain is not the heel spur itself but the soft-tissue injury associated with it. The feeling has been described as a knife or pin sticking into the bottom of your feet when you first stand up after sitting or laying down for a long period of time - a pain that later turns into a dull ache.
Diagnosis
The diagnosis of heel pain and heel spurs is made by a through history of the course of the condition and by physical exam. Weight bearing x-rays are useful in determining if a heel spur is present and to rule out rare causes of heel pain such as a stress fracture of the heel bone, the presence of bone tumors or evidence of soft tissue damage caused by certain connective tissue disorders.
Non Surgical Treatment
In extreme cases, a doctor may recommend surgery for the removal of heel spurs. Fortunately, this is the exception rather than the rule. Most cases can be resolved with a combination of icing, rest, foot stretches and supporting the foot with an orthodic shoe insert specifically designed for this condition. We recommend that you continue on to our article on Heel Spur Treatment to discover the best, speediest and most affordable methods of resolving this ailment without invasive medical procedures.
Surgical Treatment
Surgery to correct for heel spur syndrome is a common procedure which releases plantar fascia partially from its attachment to the calcaneous (heel bone). This part of the surgery is called a plantar fasciotomy due to the fact the fascia is cut. This is most often done through an open procedure as any heel spur or bursa can be removed at the same time. If the spur is not removed during the surgery, it will probably be just as successful, as the large spur is not the true problem. Some physicians use an endoscopic approach (EPF) where a small camera aids the physician during surgery with typically smaller incisions on each side of your foot.