Heel spurs are small lumps of excess bone that grow and stick out on the calcaneus, aka heel bone. They usually develop in response to friction, tightness, inflammation or injury when the body lays down extra layers of bone to try and protect itself. There are two areas where heel bone spurs tend to develop. At the back of the heel: these are usually due to conditions such as Achilles tendonitis, tight calf muscles or wearing tight footwear. These are known as posterior calcaneal spurs. Underneath the heel: these are usually due to conditions such as plantar fasciitis, muscle imbalance or altered foot biomechanics. These are known as inferior calcaneal spurs.
Heel spurs can form as a result of repeated strain placed on foot muscles and ligaments as well as from abnormally stretching the band of tissue connecting the heel and ball of the foot. Repeated injury to the membrane that lines the heel bone can also cause problems as can repeated tight pressure on the back of the heel. The causes can range from excessive walking (especially if unaccustomed to walking), running or jumping to improperly fitted or worn-out shoes. Runners, volleyball players, and tennis players, people who do step aerobics or stair climbing for exercise, those with flat feet, pregnant women, the obese and diabetics and those who wear tight-fitting shoes with a high heel are all prone to developing spurs (and plantar fasciitis) more readily.
The spur itself is not painful, however, if it is sharp and pointed it can poke into soft tissue surrounding the spur itself. As the bone spur irritates the tissue, inflammation and bruising can occur leading to heel pain. Heel spurs can affect your ability to do your usual work and/or activities, and can also trap and irritate the nerves in your heel area. They can change the way you walk, and can lead to knee, hip and low back injuries. If severe, they may require medical intervention.
Your doctor will discuss your medical history and will examine your foot and heel for any deformities and inflammation (swelling, redness, heat, pain). He/she will analyze your flexibility, stability, and gait (the way you walk). Occasionally an x-ray or blood tests (to rule out diseases or infections) may be requested.
Non Surgical Treatment
Heel pain may be associated with a heel spur, however the heel pain is usually due to plantar fasciitis, rather than a heel spur, so treatment is usually directed at the plantar fasciitis itself. Treatment usually involves application of ice to reduce pain and inflammation, special stretching exercises, and pain-relieving or anti-inflammatory medicines. Night splints or orthotics may be recommended. It may help to avoid the activities that aggravate pain, such as long walks and running. Surgery is very rarely recommended and only after other measures fail.
Surgery, which is a more radical treatment, can be a permanent correction to remove the spur itself. If your doctor believes that surgery is indicated, he will recommend an operation – but only after establishing that less drastic methods of treatment are not successful.