Heel Spurs: Causes, Symptoms, and Treatment

What Are Heel Spurs?

A heel spur is a calcium deposit that forms a bony protrusion on the underside of the heel. While heel spurs themselves are not always painful, they are commonly linked to inflammation of surrounding soft tissues, such as the plantar fascia.

Causes of Heel Spurs

Overuse and Mechanical Stress

• Repetitive stress from walking, running, or jumping on hard surfaces.

• Strain on the plantar fascia from prolonged standing or high-impact activities.

Foot Structure and Biomechanics

• Flat feet (pes planus) or high arches (pes cavus), altering pressure on the heel.

• Abnormal gait patterns or poor walking mechanics.

Risk Factors

• Obesity, increasing strain on the heel.

• Ill-fitting or unsupportive footwear.

• Age-related wear and tear on the foot structures.

• Chronic plantar fasciitis leading to prolonged stress on the heel bone.

Symptoms of Heel Spurs

• Heel Pain: Typically felt as a sharp or aching sensation, especially with the first steps in the morning or after rest.

• Localized Tenderness: Pain at the bottom of the heel, aggravated by walking or standing.

• Inflammation: Swelling or redness in the heel area due to irritation of soft tissues.

• Bone Spur Visibility: On X-rays, a heel spur may appear as a pointed or hook-like bony growth.

Diagnosing Heel Spurs

Clinical Assessment

• Thorough history of symptoms and activity levels.

• Physical examination to identify tender points and assess foot biomechanics.

Imaging Studies

• X-rays: Reveal the presence and size of the heel spur.

• Ultrasound: Assess soft tissue inflammation, such as plantar fasciitis.

Treatment for Heel Spurs

Non-Surgical Management

1. Pain and Inflammation Relief

   • Ice therapy to reduce swelling and alleviate pain.

   • Anti-inflammatory medications (as prescribed by your doctor).

2. Physiotherapy

   • Stretching Exercises: Focused on the plantar fascia, Achilles tendon, and calf muscles to relieve tension.

   • Strengthening Exercises: Improve the support of foot structures and reduce strain on the heel.

   • Manual Therapy: Techniques to address stiffness and improve soft tissue mobility.

3. Orthotic Support and Footwear Modifications

   • Custom orthotics to redistribute pressure away from the heel.

   • Transition to cushioned, supportive footwear with good arch support.

4. Load Management

   • Temporary activity modification to reduce repetitive stress on the heel.

   • Avoid high-impact activities like running during the acute phase of treatment.

Surgical Management

Surgery is rarely needed but may be considered in severe, chronic cases where conservative treatments fail. Surgery typically involves removing the heel spur and addressing associated soft tissue damage.

Recovery Timeline

• Acute Pain Relief: 2–6 weeks with consistent treatment and activity modification.

• Resolution of Symptoms: 3–6 months, depending on adherence to therapy and underlying causes.

• Prevention of Recurrence: Long-term improvements with continued use of supportive footwear, orthotics, and regular exercises.

Preventing Heel Spurs

• Wear supportive footwear that cushions the heel and provides adequate arch support.

• Maintain a healthy weight to reduce strain on the feet.

• Perform regular stretching and strengthening exercises for the foot and calf muscles.

• Gradually increase the intensity and duration of physical activities to avoid overuse.

At Palms Physiotherapy & Allied Health, we offer comprehensive care for heel spurs, including evidence-based treatment plans to manage symptoms and address root causes. Reach out to us today for personalized advice and rehabilitation support!