Heel Spur
Description:
A heel spur is a growth on the bottom of the heel bone (calcaneus). A heel spur often accompanies plantar fasciitis – a ligament in the archway of the foot. Injury to or consistent pulling of this ligament at its attachment to the calcaneus will cause spur formation over time. The pain is characterized as sharp with the first few steps in the morning and in the evening after increased activities with minor relief as it is “warmed up” during light walking and massage.
Treatment: Conservative Care:
| Rest: | The level of rest varies from decreased activities to crutches and non-weight bearing on the affected foot for 1 to 3 weeks. Avoid bare feet and shoes without support (sandals, flip-flops, house shoes, etc.). |
| Stretching: | Static stretching in the morning AND evening using the proper technique will speed recovery and minimize re-injury. |
| Medication: | Anti-inflammatory medication (e.g. Ibuprofen, Naprosyn) aspirin products, and Acetaminophen can help with the chronic pain, but are not much help with the acute pain. |
| Injection: | An anesthetic (numbing agent) mixed with cortisone (anti-inflammatory) is placed at the point of pain to relieve the sharp pain associated with the first few steps in the morning and/or pain at night after increased activities. |
| Arch support: | Temporary arch supports, supportive athletic shoes, or a higher heel on a shoe will all provide additional rest to the injured ligament. Custom molded orthotics is the best solution for immediate and long term treatment. |
| Night Splints: | A night splint is a device that keeps a constant tension on the ligament while it is healing by keeping the foot at a 90 degree angle to the lower leg. |
| Physical Therapy: | Examples of physical therapy include massage, cold therapy, contrast baths, stretching, ultrasound, and electric stimulation. |
Surgical Options:
The heel spur removal is preceded by a release of the plantar fascia. This first exposes the spur and it is then simply filed down with a special instrument. The incision is minimal (1cm to ½ inch) at the inside of the heel and sutures are removed at 2 weeks. The procedure is performed in an outpatient facility under sedation and partial weight bearing is allowed after 48 to 72 hours of non weight bearing.
