A calcaneal spur (or heel spur) is a small osteophyte (bone spur) located on the calcaneus (heel bone). Calcaneal spurs are typically detected by a radiological examination (X-ray). When a foot bone
is exposed to constant stress, calcium deposits build up on the bottom of the heel bone. Generally, this has no effect on a person's daily life. However, repeated damage can cause these deposits to
pile up on each other,causing a spur-shaped deformity, called a calcaneal (or heel) spur. Obese people, flatfooted people, and women who constantly wear high-heeled shoes are most susceptible to heel
spurs. An inferior calcaneal spur is located on the inferior aspect of the calcaneus and is typically a response to plantar fasciitis over a period, but may also be associated with ankylosing
spondylitis (typically in children). A posterior calcaneal spur develops on the back of the heel at the insertion of the Achilles tendon. An inferior calcaneal spur consists of a calcification of the
calcaneus, which lies superior to the plantar fascia at the insertion of the plantar fascia. A posterior calcaneal spur is often large and palpable through the skin and may need to be removed as part
of the treatment of insertional Achilles tendonitis. These are also generally visible to the naked eye.
A heel spur is caused by chronic plantar fasciitis. Your plantar fascia is a thick fibrous band of connective tissue originating on the bottom surface of the calcaneus (heel bone) and extending along
the sole of the foot towards the toes.Your plantar fascia acts as a passive limitation to the over flattening of you arch. When your plantar fascia develops micro tears or becomes inflamed it is
known as plantar fasciitis. When plantar fasciitis healing is delayed or injury persists, your body repairs the weak and injured soft tissue with bone. Usually your injured fascia will be healed via
fibroblastic activity. They'll operate for at least six weeks. If your injury persists beyond this time, osteoblasts are recruited to the area. Osteoblasts form bone and the end result is bone (or
calcification) within the plantar fascia or at the calcaneal insertion. These bone formations are known as heel spurs. This scenario is most common in the traction type injury. The additional bone
growth is known as a heel spur or calcaneal spur.
Some symptoms at the beginning of this condition include pain and swelling, and discomfort when pushing off with the toes during walking. This movement of the foot stretches the fascia that is
already irritated and inflamed. If this condition is not treated, pain will be noticed in the heel when a heel spur develops in response to the stress. This is a common condition among athletes and
others who run and jump a significant amount.
Sharp pain localized to the heel may be all a doctor needs to understand in order to diagnose the presence of heel spurs. However, you may also be sent to a radiologist for X-rays to confirm the
presence of heel spurs.
Non Surgical Treatment
FIRST, Reduce the acute pain. This is done by a combination of several things; injection of a synthetic relative of cortisone into the heel, a prescription of anti-inflammatory pills to reduce
inflammation, physical therapy and a special heel pad. About 50% of the time, these treatments will permanently relieve the pain. In the other 50%, the pain becomes recurrent, and the treatment
proceeds to Stage II. SECOND, Recurrent, painful heel spur is caused by the tug and pull of the plantar fascia ligament on the heel bone with each step. When the pain is recurrent, arch supports are
made to prevent sagging of the arch. The arch supports are custom-made according to the size and shape of the feet. This prevents the arch from sagging and the ligament from tugging and pulling on
the heel bone. The inflammation and pain eventually go away as the first phase of treatment is continued along with the arch supports, although the spur itself remains. THIRD, Surgery to remove the
spur is possible and is usually done as Day Surgery.
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.