What is a heel spur? What are the symptoms and treatment methods?
The heel spur is a bone-like calcium deposit between the heel bone and the sole cavity. It often starts in front of the heel and then affects the other parts of the foot. It is usually about 0.5 cm tall. So it's not always visible to the naked eye. The diagnosis of heel spur, which is called osteophyte in the medical literature, can sometimes be difficult. It is often the result of prolonged tension in the muscle and connective tissue. Repetitive stress from walking, running or jumping on hard surfaces is a common cause of heel spurs. Pain in the front of the heel, swelling, inflammation symptoms such as increased temperature is seen. However, it does not always cause pain and not every heel pain is caused by the heel spur. It is treated with anti-inflammatory drugs, orthoses and preventive measures.
What is a heel spur?
Heel spurs are pointed bone growths in the heel bone. These are the structures formed by calcium deposits under the heel bone called calcaneus. In the X-ray film, the heel spur can be seen as 1 - 1.5 cm. When there is no visible evidence on the X-ray, the condition can sometimes be called "heel spur syndrome".
The heel spur may develop due to an underlying health problem or can be seen independently. It can be located in front of the heel, just below the footbelt or behind the heel. The heel spur behind the heel is often associated with inflammation of the Achilles tendon. In this inflammatory condition known as Achilles tendonitis, applying pressure to the anterior part of the foot causes tenderness and increased heel pain. The heel spur on the anterior part of the heel is often associated with plantar fasciitis. Plantar fasciitis is a painful inflammation of the fibrous connective tissue called plantar fascia, which passes under the foot and connects the heel bone to the toes.
What causes heel spurs?
Heel spurs occur when calcium accumulation occurs on the underside of the heel bone for several months.
Local inflammation is a common cause of calcium build-up as a result of chronic stretching and tearing of the soft tissue tendons, muscles, or plantar fascia. The plantar fascia is a strip of connective tissue that connects the heel bone to the toes. Heel spurs are particularly common among athletes engaged in long running and jumping.
Risk factors for heel spurs include:
Gait abnormalities that exert excessive stress on the heel bone, ligaments and nerves near the heel
Brisk walking or jogging, especially on hard surfaces
Incompatible or poorly worn shoes, especially those without suitable belt support
Excess weight and obesity
Other risk factors associated with plantar fasciitis include:
Elderly age reduces the flexibility of the plantar fascia and increases the risk by thinning the heel-protecting fat pad.
It is more common in women.
Soft tissue damage to the foot due to impact to the heel or toe sprains can lead to heel spurs.
Diabetes
Spend most of the day standing
Frequent and short-term, excessive physical activities
To have flat footbed or high foot arch
There are also some medical conditions that can cause heel spurs. These include:
Reactive arthritis (Reiter's disease)
Ankylosing spondylitis
Diffuse idiopathic skeletal hyperostosis
Plantar fasciitis
Achilles tendonitis
What are the symptoms of heel spurs?
Heel spurs often do not show any symptoms. The most common complaints are intermittent or chronic pain. Particularly if inflammation occurs at the point of formation of the heel spur, pain may be seen, especially when walking or running. In general, the cause of pain is not the heel spur, but the associated soft tissue injury.
Many people describe heel spurs and pain in plantar fasciitis as stabbing or pin pricks in the soles of the feet when they first get up in the morning. The pain then becomes an uncomfortable pain. Generally, after sitting for a long time, sharp pain returns when standing up. Other symptoms of the heel spur may include:
Inflammation and swelling in front of the heel
Heat increase in and around the affected area
Small, naked eye-visible bone-like protrusion under the heel
Sensitivity under the heel, making it difficult to walk barefoot
How to tell the heel spurs?
Foot x-rays can be performed for diagnosis in individuals with symptoms and complaints that are thought to be heel spurs. The x-ray of the bone protrusion is the only way to ensure the presence of heel spurs. Because some people have no symptoms, the heel spur is only discovered by x-raying for another reason.
How to treat heel spurs?
The goal of heel spur treatment is to reduce the pressure on the feet, to control pain and inflammation, to promote tissue healing and to increase the flexibility of soft tissues. Treatments for heel spurs may include:
Rest. Abundant rest can reduce the pressure exerted on the foot and help reduce the inflammatory condition and associated pain and swelling in the affected area.
Application of ice. Applying ice can help reduce pain and swelling by suppressing inflammation.
Orthotic use. The ring-shaped insoles used for this purpose are used by inserting them into the shoe to absorb the pressure on the heel.
Night splint and casts
Stretching exercises
Physiotheraphy
Wear shock absorbing sneakers. It can help relieve the pressure on the soft tissues of the feet and reduce pain.
Antiinflammatory drugs. Helps reduce swelling by suppressing the inflammatory process.
Extracorporeal shock wave therapy (ESWT). High-energy sound waves are directed to the region of interest to promote healing of the plantar fascia.
Is taken Prolotherapy. The healing process is stimulated by injecting an irritating agent such as dextrose into the damaged soft tissue.
PRP. A natural substance from the person's own blood is injected into the heel area. This application accelerates tissue healing.
Acupuncture. Sterile needles or laser beams dipped in certain areas of the body stimulate the healing and repair mechanisms of the body.
Steroid injections. Reduces swelling and pain in the affected area. They are more powerful drugs used in the absence of anti-inflammatory drugs.
Operation. In rare cases, surgery may be necessary to remove the heel spur. In most cases, other treatments are sufficient and no surgery is required.
If the heel spur is developed due to a type of inflamed arthritis, the symptoms may regress with the treatment of the underlying condition.
Heel spur
There is no special medicine developed for heel spurs. Drugs used in treatment help to control complaints by suppressing the inflammatory process and accelerating tissue healing. Drugs used for this purpose include:
Painkillers and anti-inflammatory drugs: Ibuprofen, naproxen, such as drugs can be taken orally under the supervision of a doctor.
Creams, ointments and gels: Anti-inflammatory and pain relieving creams, gels or ointments may be useful.
Steroid injections: If it does not work with other treatments, steroid injections are tried to the patient area before surgery is considered.
Heel spur surgery
More than 90% of patients recover with non-surgical treatments. If other treatments cannot cure complaints after a period of 9 to 12 months, surgery may be necessary to relieve pain and improve mobility. Surgical techniques include:
Release of plantar fascia
Removing the heel spur
Pre-operative examinations and tests are performed to determine suitable candidates for surgery. After the operation, the doctor's instructions such as resting, applying ice, raising the foot should be followed. In some cases, patients may need to use post-operative bandages, splints, throws, surgical shoes, crutches or walking sticks. Possible complications of heel spur surgery include nerve pain, recurrent heel pain, permanent drowsiness in the area, infection and a hard scar called scar. In addition, there is a risk of foot cramps, stress fractures and tendonitis after plantar fascia release.
Heel spur exercises
The heel spur is a result of exposure to chronic tension due to the short muscles and ligaments of the foot and calf. For this reason, exercises to help elongate and stretch the soft tissues in the region are effective in reducing the complaints. Therefore, foot and calf stretching exercises can be performed regularly to aid in the treatment of heel spurs. Some exercises that can be done for this purpose are as follows:
Stretching of plantar fascia and calves: A step or bench is placed with the toes with the soles of the foot parallel to the ground. The heel remaining in the cavity is lowered until you feel tension. Wait for a few seconds in this position and the heel is raised again. This movement is repeated several times.
Stretching of plantar fascia and calves: Sitting on the floor or bed with legs outstretched. A towel is wrapped around the toes and pulled towards the end of the towel until it feels tension.
Stretching the plantar fascia: Sit on a chair and place the calf on the other leg diagonally. The fingers of the foot are then held on to the same side by hand. It is a very effective exercise.
Stretching the calf muscles: lean against a wall or pole. One leg is left behind and the body load is given to the other leg. Then lean forward until you feel a tension in the hind limb.
How does heel spurs go?
There are a number of natural treatment options for heel spurs. Some of them can be listed as:
Epsom salt bath. Epsom salt is a naturally occurring healing salt containing magnesium sulfate. For heel spurs, sprinkle some Epsom salt in the water and dip into the feet. Heels can be gently massaged with feet in water.
Massage with essential oils. Pure essential oils such as rosemary or lavender can reduce pain due to their anti-inflammatory properties.
Apple cider vinegar. Apple cider vinegar is known to remove excess calcium from the bone and provide relief. Feet are immersed in warm water containing a few drops of apple cider vinegar or a towel soaked with vinegar is wrapped around the heel for several minutes.
Carbonate. Half a teaspoon of carbonate and 1 teaspoon of water by mixing a paste is prepared and applied to the heel massage.
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