Heel Spur: Definition, Symptoms, Causes, and Treatment

Heel spurs are a common health issue in the general population.

Heel spurs are a common health issue in the general population. While they usually occur in one foot, in some cases, they can develop in both feet. Various treatment methods are available to help alleviate the pain experienced by those with heel spurs.

What is a Heel Spur?

A heel spur forms when calcium deposits accumulate between the heel and the arch of the foot. These calcium deposits can harden into a bony projection that protrudes from the heel area. Heel spurs can vary in shape, such as point-like or hook-shaped, and may extend from the heel to the arch in the middle of the foot. Heel spurs often occur together with plantar fasciitis, which is the inflammation of the ligaments on the sole of the foot.

Plantar fasciitis results from the inflammation of the ligament connecting the heel to the front of the foot.

The web-like ligament that connects the heel to the front of the foot is called the plantar fascia. This thick ligament supports the foot arch, allowing smooth movement during activities like walking and running. However, due to its frequent use in daily activities, the plantar fascia can become prone to wear and tear over time. Excessive pressure on the heel also damages the plantar fascia ligaments. As a result, the plantar fascia becomes inflamed, leading to pain and stiffness in the heel. Heel spur is one of the most common orthopedic issues and is frequently observed in runners and overweight individuals. Wearing inappropriate shoes that do not support the foot structure also increases the risk of heel spurs.

What Are the Symptoms of a Heel Spur?

The classic symptom of a heel spur is sharp, stabbing pain in the heel. For some individuals, this pain may feel like an ache or a burning sensation. While the pain primarily occurs in the heel, it may extend towards the middle of the foot in some cases. Small bony protrusions may be noticeable in the heel area of people with heel spurs. The intensity of heel spur pain is generally higher in the morning when a person takes their first steps. The pain tends to decrease throughout the day but can intensify when standing for long periods or after standing up following prolonged sitting. Climbing stairs may also be challenging for those with heel spurs. While the pain may not be severe during exercise, it often worsens after the exercise session ends.

What Causes a Heel Spur?

Heel spurs occur when the soft tissues in the heel become damaged due to long-term wear and tear of the foot's muscles and ligaments. A tear in the membrane surrounding the heel bone can also lead to the formation of a heel spur.

The following factors increase the risk of heel spur development:

• Athletic Activities: Activities like running and jumping can cause wear and tear in the heel and arch of the foot.
• Movement on Hard Surfaces: Frequently walking, running, or jumping on hard surfaces can wear down the structures in the heel.
• Heel Injury: Traumatic injuries to the heel may cause tearing in the membrane surrounding the heel bone, creating conditions for a spur to form.
• Age: The likelihood of heel spur formation increases with age.
• Gender: Heel spurs are more commonly observed in women than in men.
• Weight: Excess weight increases pressure on the heel, accelerating wear and tear in that area.
• Improper Footwear: Wearing shoes that do not adequately support the foot or fit improperly can also be a risk factor for heel spurs.

Certain underlying conditions can also contribute to heel spur development, including:

• Reactive arthritis (Reiter's disease)
• Ankylosing spondylitis
• Diffuse idiopathic skeletal hyperostosis (DISH)

How to Recognize a Heel Spur?

Since heel spur symptoms can resemble those of other foot-related conditions that cause heel pain, it’s not possible for a person to self-diagnose. Consulting a doctor is essential for diagnosis. The first step in diagnosing a heel spur involves taking the patient’s medical history and evaluating their complaints. Key aspects for diagnosis include the location of heel pain, when it intensifies or lessens, and whether the patient has any risk factors for heel spurs.

During the heel spur examination, the doctor checks for signs of inflammation, such as redness or swelling in the foot. Tenderness in the heel is an important finding for diagnosing a heel spur. One of the most important diagnostic tests is an X-ray of the foot, where bony protrusions on the heel may be visible. Even if these protrusions aren’t noticeable to the eye, they can be clearly seen on an X-ray.

What is the Treatment for Heel Spurs?

Heel spur treatment typically begins with lifestyle changes and rest.

People with heel spurs can relieve foot pain by applying a cold compress. Ice packs can be applied to the painful area for 15 minutes to numb the region and help reduce swelling. In cases of severe pain caused by a heel spur, corticosteroid injections may be used to reduce inflammation in the foot. These medications help alleviate both pain and other inflammation-related symptoms. For sudden, short-term pain related to heel spurs, simple pain relievers can be used.

Physical therapy modalities can also aid in relieving long-term, chronic pain that may result from heel spurs. Since corticosteroids cannot be used continuously for pain control, physical therapy exercises help strengthen the muscles and ligaments in the heel and arch of the foot. A physiotherapist teaches the patient how to perform these exercises, which they can later do independently at home.

One of the most commonly recommended treatments for heel spurs and plantar fasciitis is rest. Rest helps both to alleviate acute pain and prevent the condition from worsening. It is especially important for easing pain after prolonged standing. Orthopedic insoles placed in the shoes provide arch support and can help reduce heel pain. People with heel spurs should also opt for comfortable shoes that provide full foot support.

If heel spur pain is very severe and continues to worsen, surgical intervention may be necessary. During surgery, the heel spur is removed, and in some cases, the plantar fascia is also released. Heel spur surgery not only reduces pain but also eliminates movement limitations. Most patients who undergo heel spur surgery also have plantar fasciitis, as alternative treatment methods are usually sufficient for those with only a heel spur. After heel spur surgery, the patient can apply cold packs to the surgical site to accelerate the healing process. The patient will also need to rest before bearing weight on the operated foot.

Heel spurs are a significant orthopedic problem that can restrict many daily activities, especially walking. Therefore, it’s a condition that should be treated. Factors like the severity of the patient’s pain and the extent of foot deformity influence treatment. After treatment, patients can continue with their daily activities more comfortably. Those who suspect they may have a heel spur are encouraged to visit a healthcare center without delay.