You have heel pain, and you’ve just been diagnosed with heel spurs. Safe to assume that the spurs are causing the pain, right? Don’t be so sure. About 95 percent of heel spurs are asymptomatic—they don’t hurt. If you have heel pain, it’s far more likely to be caused by plantar fasciitis, an inflammation of the ligament, known as the plantar fascia, that connects the heel bone (calcaneus) to the bones near the front of the foot.
So what exactly is a heel spur? And, if it doesn’t usually cause pain, why do you need to know? Read on.
What Are Heel Spurs?
Heel spurs are abnormal growths on the front of the calcaneus bone. About half of people who have plantar fasciitis also have heel spurs. But contrary to popular belief, most of the time it’s not the heel spurs that hurt, it’s the plantar fasciitis itself.
Plantar fasciitis is inflammation of the plantar fascia. It’s usually an overuse injury, meaning it develops because you’re on your feet all day, you’ve increased your running miles, things like that. Older people, those who are obese and people with certain foot anatomies like flat arches are more likely to develop plantar fasciitis than others.
The constant pressure on and stretching of the plantar fascia and the inflammation from the plantar fasciitis cause the heel bone to begin to break down. That’s where heel spurs come in. Your body tries to repair the damage to the bone by sending calcium to it. That calcium builds and builds and eventually starts to protrude off the bone. That’s a heel spur.
Other Causes of Heel Spurs
Plantar fasciitis doesn’t always cause heel spurs, and heel spurs aren’t only caused by plantar fasciitis. Here are some other reasons you might have a heel spur.
- You are overweight
- You have arthritis
- You have issues with the way you walk
- You wear flip-flops, or shoes that don’t fit well
Diagnosing Heel Spurs
Heel spurs can be difficult to diagnose by themselves. You generally can’t feel a heel spur under the skin, and if it’s not causing you any pain, you probably won’t know it’s there. If a patient comes to me with plantar fasciitis, I know that there’s a good chance I’ll find a heel spur too.
If I suspect a patient has a heel spur and I feel it’s important to find out for sure, I will have the patient undergo an X-ray or an ultrasound. These are forms of diagnostic imaging that allow me to see under a patient’s skin, so to speak. X-rays are useful for visualizing bone, while ultrasound allows me a better view of the foot’s internal structure.
Heel Spur Treatment
Heel spurs and plantar fasciitis are usually treated together and can often be alleviated without surgery. Because heel spurs rarely cause pain, it’s usually my patients’ plantar fasciitis that is more worrisome.
There are a number of nonsurgical treatments for plantar fasciitis and heel spurs. I typically recommend my patients begin with resting the injured foot and applying ice. Ice the sole of the foot three times a day for 20 minutes at a time.
Shoes can make a big difference to plantar fasciitis pain. Look for comfortable shoes that fit well. Custom orthotics, which are special shoe inserts made for your foot, can further decrease the pain of plantar fasciitis and heel spurs. You can also use splints at night to stretch the foot.
Pain relievers like nonsteroidal anti-inflammatory drugs (NSAIDs) can treat the symptoms of plantar fasciitis. Physical therapy aimed at stretching out and strengthening the calves can also help.
If these conservative treatments don’t work, ask your foot and ankle specialist what other options are available. For severe cases of plantar fasciitis, surgery to detach the plantar fascia from the heel bone could be a possible treatment.
If you have heel pain and think you may have a heel spur or plantar fasciitis, request an appointment with me. In my practice, I have treated hundreds of cases of both. I can asses your situation and put you on a treatment plan that’s right for you.