Heel spurs (plantar fasciitis) are common lesions of the fascia and bone tissue. The superficial layer of periosteum on the heel grows and forms spines or osteophytes.
Since the heel bone almost constantly bears the load of the entire weight of a person when moving, the disease is more likely to bother obese people. And pain in the foot contributes to the causes of low mobility and aggravates obesity.
According to ICD 10, pathology is classified as diseases of the connective tissue and musculoskeletal system. Included in the group of density and structure disorders. Has a separate code M77.3.
Medical statistics show that in 80% of cases, symptoms of heel spurs are detected among women. Residents of cities and rural areas get sick equally often.
Heel spur is a well-explained pathology, its causes are known and studied. These include:
In all cases of impact on the plantar ligament with a heel spur, more or less rupture of its fibers occurs. The inflammatory process ends with the formation of scars, which, due to their inability to stretch, shorten the fascia.
The inelastic ligament is constantly injured by any unevenness in the soil and accumulates calcium salts. The result is a long-term inflammatory process that affects the surface layer of the periosteum of the heel bone. And calcium is deposited in the form of bone growths.
Diseases that cause heel spurs include those that are accompanied by poor circulation in the legs and metabolic failure. These include:
Symptoms of heel spurs include pain in the foot:
Here sharp pain is detected when pressing
There are cases when a person does not feel large thorns, but flat and small ones cause severe pain.
“Starting” pain is considered typical in the morning when getting out of bed or after prolonged sitting. During the day, patients note that the pain subsides, but intensifies in the evening.
Altered support leads to transverse flatfoot. It is especially difficult for people with bilateral heel spurs to move around.
The diagnosis of plantar fasciitis is not difficult to make based on the characteristic manifestations and complaints of the patient. Indisputable and objective signs of a heel spur are determined on an x-ray.
An image of the bones of the foot reveals areas that are similar in density to a continuation of the bone tissue of the heel. The length of the spine varies from 3 to 12 mm, it often looks like a “beak” and bends towards the fingers.
On palpation, maximum pain is observed in the subcalcaneal fossa and above the area of bone changes.
To finally clarify the nature of the pain, you need to consult an orthopedic doctor. He will help you choose a treatment method.
When a baby begins to walk by the age of one year, he needs a period to adapt the foot to the most comfortable position. Therefore, parents notice that the child prefers to walk on his toes or has a clubfoot. In children, the ligament of the arch of the foot is quite elastic and strong. It can withstand temporary overloads.
If during the period of maximum growth a child plays sports intensively or gains excess weight, this leads to the development of flat feet and curvature of the arch of the foot. In adulthood, all conditions are created for the development of a heel spur.
Shoes with a heel spur become a big problem for the patient. Special inserts - orthoses or insoles - help. They allow you to slightly redistribute the load on the arch of the foot.
It is impossible to select the required type on your own. Only a specialist doctor will indicate it. Insoles must be worn constantly, inserted into any type of footwear (shoes, boots, sandals). For the summer, you can purchase semi-insoles with Velcro. They are held in the arch area and are not visible from the outside.
At the initial stage, spurs are treated with special night orthoses, which are put on in the evening and not removed at night.
You can choose soft heel pads that absorb shock when walking and reduce pain.
Insoles are sold in orthopedic stores or pharmacies; they have their own size and number
For children, you should purchase shoes according to age:
For adults, shoes with spring soles are recommended. Since polymer materials are used, which quickly lose their properties, shoes must be changed frequently.
The problem of diet with a heel spur is not as acute as with diseases of the stomach or intestines. Nutrition does not have a quick pain-relieving effect. Plantar fasciitis, like any inflammatory process in the body, is accompanied by increased “acidification” of the environment.
It has been established that to prevent the deposition of calcium salts it is necessary to change the tissue reaction to alkaline. In this process, the heel spur diet makes a difference and helps stop ossification. Therefore, nutritionists recommend for patients:
You can arrange watermelon fasting days, they promote weight loss and remove acid radicals
Prevention of heel spurs begins in childhood with the selection of the right shoes. It is not recommended to buy used shoes for your child. While its appearance is preserved, it loses the shock-absorbing properties of the sole and contributes to the development of flat feet.
Your daily gymnastics routine should include stretching exercises for the plantar fascia. They can be easily done at work.
Controlling your weight and using fasting diets is not only a matter of beauty, but also of preventing pressure on the arch of the foot.
Wearing high heels for women requires additional foot training, daily work with your feet, and restoration of their condition. Perhaps heels are not so necessary and it’s easier to give them up?
Treatment of the underlying disease in the presence of diabetes mellitus, atherosclerosis of the blood vessels of the legs, and arthritis prevents the development of spurs. Any heel pain should be consulted with a podiatrist. His recommendations will help you move without pain.
A heel spur is a styloid bone growth on the plantar surface of the heel bones. But there are cases when pain in the heel area occurs not because of the so-called thorns, but because of the affected tendons.
Heel spurs most often bother women over 40. People who are overweight, have diseases of the large joints of the legs, spine, or have flat feet are also predisposed to this disease.
Heel pain can occur when the tendon is injured, for example, due to a tear or sprain. Overload of the feet when wearing high-heeled shoes, bruises of the heel bone, for example, due to jumping from a height, contributes to the development of heel spurs.
Inflammation of the heel spur also occurs as a result of chronic inflammatory diseases of the joints: gout, psoriatic arthritis or ankylosing spondylitis.
When examining such patients, blood tests most often reveal specific markers for psoriatic arthritis or ankylosing spondylitis and a clear increase in acid levels for gout.
Heel pain can also occur with some infectious diseases, especially genital diseases, for example, chlamydia or gonorrhea, which often occur rather hiddenly. This is why it is necessary to undergo a full medical examination to determine the true cause of heel spurs.
Main symptoms. In the picture of the disease with a heel spur, one main symptom predominates - heel pain, which can occur suddenly, acutely or gradually increase over time. Many people compare this pain as “like a needle in the heel.”
If you experience intense heel pain, it is not recommended to self-medicate. In such cases, they consult a doctor (orthopedist, rheumatologist or arthrologist), who establishes the cause of the pain and, of course, the diagnosis of the disease. At the initial appointment, during a palpation examination of the heel, the doctor determines the point of greatest pain. As a rule, it is located in the area of the inner process of the calcaneal tubercle, that is, closer to the inner edge of the heel bone. Afterwards, the doctor may prescribe an additional examination: biochemical and general blood tests, x-ray diagnostics.
X-rays reveal what appears to be a nail—a distinctive bony protrusion on the heel bone called a heel spur. However, the level of pain, as a rule, does not depend on the size of the heel spur. The spur can be quite large, but there will be no pain. And sometimes an X-ray does not show a spur at all, but the patient has all the signs of inflammation of the heel tendons and severe pain in the soles of the feet. The intensity of pain does not depend on the degree of bone deformation, but on the condition of the tendon fibers, the reactivity of the patient’s body and some other reasons.
After a detailed examination, the necessary treatment is prescribed. To eliminate heel pain itself, anti-inflammatory drugs, the introduction of drugs into the heel area using electrophoresis, laser therapy, and in some cases single injections of corticosteroid hormones are used.
When treating heel spurs caused by overload or injury to the tendon, patients are prescribed complete rest for 2–3 weeks. Anti-inflammatory drugs are often prescribed. Surgical treatment usually results in a complete cure, but recovery lasts from 3 to 6 weeks.
Hormonal treatment for decompensated diabetes mellitus, hypertension, gastric ulcer in the acute phase and inflammatory processes on the skin is contraindicated. When other methods fail, radiotherapy is performed.
In order to prevent exacerbation, during the entire period of treatment it is advisable, if possible, to follow a gentle regime for the legs. And, of course, the main treatment measures should be aimed at the main cause of the heel spur. For arthritis, appropriate therapy should be carried out, for flat feet, orthopedic insoles should be selected, and if blood circulation in the legs is impaired, vasodilators should be taken. If you follow medical recommendations, heel pain usually disappears in 2-4 weeks and in most cases does not recur.
Plantar fasciitis is a disease much better known to the general population as a heel spur. Heel spurs occur as a result of constant trauma to the ligament that connects the tubercle of the heel bone and the metatarsal bone. That is, it is stretched across the entire longitudinal arch and maintains it in an elevated state, providing a person with comfortable walking. But sometimes permanent, chronic damage to this ligament causes inflammation, at the site of which calcium salts begin to be deposited and a bone growth forms.
In medicine, such a growth is called an osteophyte. At first, when the disease does not yet manifest itself with any symptoms, a heel spur can only be identified using an x-ray. Moreover, it is usually done for a different reason. If the osteophyte reaches a significant size, begins to compress the vessels and nerves, ischemia and disruption of tissue trophism occurs, resulting in a burning pain, first of low intensity, then more intense, and over time it can deprive a person of the ability to move normally. Spurs can appear both in the plane of the fascia and above it. They can affect one or both heels.
Symptoms of a heel spur include discomfort or a foreign body sensation in the heel. There is a feeling as if the heel bone continues into this osteophyte.
Another symptom is pain. Moreover, the determining characteristic of its intensity is not so much the size of the formation as the distance between it and the nerve endings and vessels, since when a vessel is compressed, ischemia of a certain area of the foot can begin, which is an extremely unfavorable situation. While you sleep and your foot is relaxed, the fascia contracts and the pain goes away. In the morning, as soon as you stand on your leg, the fascia stretches under the influence of the load, and you experience severe pain. Affecting one foot is not so bad, but if the disease affects both legs, walking becomes very difficult.
Why does a heel spur occur and how to avoid it? Orthopedic specialists identify several reasons for the formation of heel spurs. One of the main ones is flat feet. With this disease, the plantar fascia is initially weakened, its function supporting the longitudinal arch is insufficient, and the fascia is constantly under increased stress. As a result of its excessive stretching, microtears occur, inflammation appears in this place, and calcium deposition begins. This is how an osteophyte is formed.
The second most common condition is overweight. In this case, an additional load arises, but otherwise the mechanism of formation is absolutely the same as with flat feet. Athletes, especially track and field athletes, are also at risk. They train for several hours every day, which leads to incredibly high tension on the plantar fascia, damaging it. The likelihood of developing heel spurs increases in people suffering from joint diseases such as arthrosis or gout.
Naturally, any disease is easier to prevent than to treat. Therefore, let’s look at what prevents the development of this disease includes.
First of all, this is the elimination of risk factors. If you are overweight, you need to reduce it to an acceptable level. How to calculate this level? For this purpose, medicine uses this indicator of body mass index. It is equal to the ratio of mass in kilograms to the square of height in meters. That is, if your height is 168 cm (1.68 meters) and your weight is 60 kilograms, your body mass index will be 60/1.68 * 1.68 (approximately 21.4). The norm is from 18.5 to 25. Anything lower is underweight, anything higher is signs of obesity. You should lose weight gradually by eating right and doing physical exercises, which will be selected for you by a qualified trainer and your doctor.
To prevent flat feet, you should sometimes walk barefoot on sand or grass; women are not recommended to wear high-heeled shoes: they should not exceed three to four centimeters in length. But it is worth noting that shoes without heels will not work either. You should also avoid shoes with a front that is too narrow. Shoes are not an item in your wardrobe that you should skimp on. Choose high-quality, comfortable shoes, and then in the future you will not have to spend money on treatment. If flat feet have already occurred, be sure to consult an orthopedist. He will give recommendations on exercise and massage, and also advise which orthopedic salon is best to go to. There they will create shoes for you that support and correct the arch of your feet, making them as comfortable and convenient as possible.
If you suffer from chronic joint diseases, you need to be registered with a doctor in order to prevent exacerbations and, if they occur, to stop them in time. Timely intake of non-steroidal anti-inflammatory drugs, and sometimes hormones, if necessary, will protect you from heel spurs. So, you should immediately consult a doctor if you discover the above signs of a heel spur. This could be your local physician or orthopedic traumatologist.
After collecting anamnesis and conducting examination and palpation, the doctor will issue a referral for an x-ray. In the image, you can see the heel spur itself, which looks like a growth on the heel bone, or see signs of inflammation of the plantar fascia - its thickening and the deposition of calcium salts. Thus, diagnosing heel spurs is not particularly difficult. The most important thing is to learn to listen to your body and not put off going to the doctor. Now the main question arises: how to cure a heel spur?
Over the course of many years, a system for diagnosing and treating this disease has been developed throughout the world. Today, there are different methods of treating heel spurs, but mostly it is conservative. There are many folk recipes that help combat this problem. But their effectiveness is still in question. It is better to trust modern medicine and follow the advice of your doctor. For heel spur disease, treatment is carried out mainly through physiotherapeutic procedures. Warming up, which is usually done in the amount of ten to twelve, helps a lot. Physical methods of influence such as electromagnetic radiation, ultrasound, and laser are used. Massage and therapeutic exercises help well. The most important treatment measure is the selection of an orthopedic insole, which will relieve the plantar fascia and give it time and opportunity to recover.
The most important thing is to eliminate the cause of the disease.
To do this, you may have to lose excess weight, correct flat feet, create an optimal training regimen for athletes, and promptly treat joint diseases. Novocaine blockades are mainly used as drug treatment. They are aimed at relieving severe pain, and also have an anti-inflammatory effect, improve blood circulation and relieve stress on the ligament. The question of how to get rid of heel spurs is not entirely correct. Surgical treatment is performed extremely rarely and only if there is a strong, unrelieved pain syndrome, that is, direct removal of the heel spur will occur under these conditions. If we simply remove the spur, then the cause of its occurrence will remain and the osteophyte will form again.
Sometimes they use shock wave therapy rather than surgical removal. This is reminiscent of crushing kidney stones, which is done with ultrasound. Here the principle of operation is approximately the same. A source of waves of a certain frequency is directed to the osteophyte and destroys it. The remaining calcium salts are gradually absorbed by the surrounding tissues. But this method is limited in application; it cannot be used in pregnant women and people suffering from blood clotting disorders. Thus, to the question whether a heel spur can be cured, doctors give an affirmative answer. But it won’t be possible to do this quickly. The average duration of treatment will be from four to eight weeks.
The most effective treatment for heel spurs is only possible with full dedication on the part of both the doctor and the patient. After all, this is largely the work of the patient himself: to correctly follow all the recommendations given to him, despite the fact that this may be quite difficult. If diagnosis is delayed and there is no proper treatment, complications may develop. These include loss of mobility in humans. As we said earlier, the pain can be very intense. If both feet are affected, it makes walking completely impossible. In such a situation, the doctor prescribes strict bed rest and applies the novocaine blockade, which we talked about when we discussed the methods of treating heel spurs.
If the pain is intense and mobility is only partially lost, the doctor recommends switching to easier working conditions. If this problem occurs in an athlete, he will have to temporarily limit training, and in some cases, abandon it forever. The next complication is the recurrence of heel spurs, which can occur when only symptomatic treatment is used, that is, removal of the osteophyte itself, without identifying the etiology (reason for formation) of the spur and without influencing it. This is a very unpleasant complication, since treatment will have to start all over again. In addition, as a result of constant trauma and irritation of nerve endings, a neuroma can form. This is a benign formation consisting of nerve cells. It must be removed as it causes pain.
If surgery was performed, all the characteristic postoperative complications are likely. Infection and suppuration of sutures, prolonged healing and untimely restoration of the patient’s motor activity. If a nerve is damaged during surgery, this can lead to a condition called tarsal tunnel syndrome. It usually occurs on the hand of people who work on a computer for a long time and use a mouse when working. Its analogue on the foot is characterized by constant aching pain along the nerve. Thus, we see that this problem must be diagnosed in a timely manner and treatment started immediately. It is worth setting yourself up for a fairly long period of treatment and not expecting quick results. It is better to actively engage in prevention: eat right, do gymnastics, walk barefoot more and regularly visit the doctor, because any disease, as mentioned above, is easier to prevent than to treat.
Having discovered a heel spur after a thorough diagnosis, most patients believe that they can safely give up on maintaining an active lifestyle. However, it is not. Today, plantar fasciitis is quite treatable, however, in order to restore the mobility and healthy condition of the foot, the patient will have to spend a fairly large amount of time, effort and money on treatment (especially if surgical or medicinal elimination of the disease is planned).
Plantar fasciitis is essentially an inflammatory process that occurs in the plantar fascia. When such a disease is detected, patients report constant pain, cramps, and a burning sensation in the heel. Often, in the initial stages of heel spur development, people do not observe any external changes in the lower extremities, and that is why they put off going to the doctor. More than half of patients seek the help of specialists only when it becomes impossible to walk - the pain does not stop for a second, and soft tissues begin to swell due to inflammation.
Orthopedists and traumatologists advise taking diagnostic measures when even minor symptoms appear, since otherwise, instead of therapeutic treatment, you will have to resort to surgery or the use of drug blockade.
To clarify the causes of plantar fasciitis, we should consider the structure of the human foot. Today, highly specialized doctors (orthopedists) consider the foot as a complex organ consisting of more than 25 bones and 33 joints. All parts of the limb are connected by muscles and ligaments - thanks to them, the mobility of the legs and the maintenance of balance are ensured. Most of the body weight, as well as mechanical impacts when walking, jumping and standing in place for a long time, is assumed by the plantar fascia (its other name is the plantar aponeurosis), or, more precisely, the segment where it is attached to the heel bone.
As the disease progresses, cracks and small tears appear in the plantar fascia, in which inflammation begins to progress. Thanks to the amazing regenerative properties of the tissues of the human body, the plantar fascia can be restored if the limbs are provided with proper rest. That is why, in the initial stages of heel spur development, patients report discomfort only when walking. However, with the appearance of new loads on the foot, as well as the development of osteophytes (bone formations), microdamages reappear in the elastic tissues, which renew and accelerate the inflammatory process.
Recently, doctors have discovered disappointing statistics - every year more than 1.5 million people turn to medical institutions with suspected heel spurs, and most of the patients are middle-aged women. After careful research into the occurrence of the disease, experts have outlined a list of the root causes of heel spurs, including:
All of the above ailments can lead to inflammation of the plantar fascia, which will lead to decreased mobility of the foot, the appearance of increasing pain in the heel, deterioration of metabolic processes in the lower extremities, and swelling of elastic tissues damaged by the disease.
In order to prevent the disease, it is necessary to periodically carry out diagnostics, including MRI and X-ray of the foot, examination and consultation with a specialist, donating blood for tests, etc. The symptoms of heel spurs are quite similar to other diseases of the musculoskeletal system, therefore, during the examination, doctors They try to identify the true causes of discomfort in the lower extremities and prescribe the correct treatment based on the results obtained.
Some people are more susceptible to developing heel spurs. For example, the risk group includes professional athletes (especially those involved in athletics), women who prefer beautiful, but not very comfortable shoes with high heels, people who, due to their duty, have to spend a long time on their feet. In addition, plantar fasciitis quite often develops during pregnancy, as well as in patients aged (50 years and older), however, in the latter case, this is due to completely natural aging processes that occur throughout the body.
In conclusion, it is worth saying that it is quite possible to cure plantar fasciitis, however, it will be much better if a person at risk takes preventive measures, including:
Only by following these recommendations can you avoid lengthy and burdensome treatment for heel spurs, maintaining your health for many years.
A few days ago my heel started to hurt when walking for a long time. The symptoms are similar to a heel spur. Tell me, how do orthopedists diagnose heel spurs, by x-ray or simply after examining the foot? First, I'll change my shoes. If it doesn't help, I'll see a doctor.
Hello Olga! The diagnosis is made based on a combination of factors; first, the heel area and foot are examined, palpated, your sensations are recorded, then an x-ray is taken. By the way, the picture may not show anything, because... The cause of heel spurs is inflammation, and a bone spur is formed as a result of this inflammation. The growth simply may not have time to form for you. The right shoes won't hurt, but in any case, don't delay going to the doctor. By the way, you can sign up online here.
A heel spur is a bony growth that forms at the site of tendon attachment, which causes pain and discomfort in the part of the sole.
A bony growth (osteophyte) on the surface of the sole of the foot in the heel area is called a heel spur. It resembles a thorn and presses on the soft tissues of the leg, causing excruciating pain. Heel spurs come in different sizes, from 4 millimeters to 12 mm. The tip of the “spur” is directed towards the fingers and slightly curved upward.
It is believed that a heel spur occurs as a result of stress on the heel area of the foot, which happens with flat feet. There are cases when its occurrence is due to age factors, rheumatism, vascular and neurodystrophic disorders, as well as injuries. To this list of possible causes of heel spurs, you can add subcalcaneal bursitis, Achilles bursitis and fasciitis.
The fascia or muscle tissue of the sole is subjected to serious stress throughout the day. When these tissues are damaged, inflammation can develop and, as a consequence of inflammation, the appearance of a heel spur.
At the beginning of the last century, the main cause of spurs was injuries, but today, more and more often, flat feet or excess weight can be called its cause. Women are especially susceptible to the development of this foot disease; 80% of the total number of patients are city residents.
No one is immune from the occurrence of spurs. They can occur either on one of the heels or on both, regardless of the person’s age, with the caveat that in old age the risk of spurs increases. At a young age, this disease affects people who train and play sports especially intensively, thereby causing stress on the feet.
A sign of spur formation is pain in the heel when you stand on it. The most painful are the first steps after waking up, as well as after a long period of immobility. This pain is also called "starter pain." It subsides during the day and then intensifies again, this time in the late afternoon.
This pain occurs on the inside of the heel area or it spreads across the entire surface of the sole of the foot. This pain is often compared to the pain of a nail pierced into the leg, it is so burning and sharp. Trying to reduce the load on the sore foot, a person changes his gait, and if spurs appear on both legs, it becomes simply impossible to walk.
93% of people suffering from heel spurs change their gait by shifting their center of gravity from the heel to the forefoot and its outer part. It is this change that leads to improper load distribution and causes transverse flatfoot. A visual examination, as a rule, reveals nothing, and pathological changes go unnoticed. Only when pressing on the tubercle of the heel bone from the side of the sole does it cause pain.
People who are overweight are the most vulnerable category to develop spurs. This is due to the load on the legs. In addition, people suffering from diseases of the spine, joints of the lower extremities and flat feet are also susceptible to this disease, since in all of these cases there is an uneven distribution of body weight. The above categories can also include athletes who are professionally involved in athletics, in particular running, during which the load on the feet is very high.
The pain of a heel spur also increases due to the thinning of the layer of fatty tissue in the heel area. This layer of fat acts as a shock absorber while walking.
Pain in the heels does not mean that a person has this disease. If the symptoms of a spur are present, it is better to contact an orthopedist or surgeon in order to confirm or refute the possible diagnosis. There are some diseases whose symptoms are similar to those of heel spurs.
Similar diseases are rheumatoid arthritis, ankylosing spondylitis, and Reiter's syndrome. These diseases can be identified by performing a biochemical blood test for the presence of rheumatoid factors.
A heel spur that occurs in a person can be seen on an x-ray. The pain from a spur depends not only on its size, but also on how sensitive the tissue is. Very often, a large spur does not cause as much pain as a small one, sometimes invisible in the picture, can cause. Therefore, to confirm the diagnosis, in addition to x-rays, it is necessary to perform an ultrasound.
In 25 cases out of 100, this disease leads to a decrease in a person’s mobility. If the pain is particularly severe, then bed rest and gentle working conditions are prescribed. Leading a normal lifestyle becomes impossible. This fact is especially difficult for athletes and people who previously led an active lifestyle. But in the conditions that have arisen, when you experience severe pain with every step, it becomes very difficult to maintain the previous regime.
Preventing heel spurs is entirely possible. To do this, you will need to do everything that will prevent flat feet, wear and tear of the bone in the heel area and inflammation in the soft tissues of the foot.
People who are overweight should take steps to help reduce their weight, thereby reducing the stress on their feet. It is recommended to do foot massage and leg exercises, and often walk barefoot on the grass and sand, which will improve blood circulation in the feet.
For flat feet, it is better to start timely treatment, because it is fraught with the development of heel spurs. It is better to use orthopedic insoles instead of regular ones, and in general, if you experience foot pain, you should immediately consult an orthopedist.
Comfortable shoes are also important in preventing this disease. It should be low-heeled, maximum 4 centimeters, and should not squeeze or injure the feet. High heels increase the risk of heel spurs. But the absence of a heel also has a negative impact on the condition of the feet.
Wearing shoes without backs is also not recommended, since the arch of the foot in them is in a tense state. Such shoes can be used for temporary wear, but for everyday long-term wear you need to choose one that does not fall off the foot and stays on it well. A narrow shoe toe is also highly undesirable.
Today, treatment for heel spurs consists of providing unloading, ultrasound therapy, mineral baths, local administration of corticosteroids, and radiotherapy. If these methods are ineffective, then they resort to an operation during which the bone growth is removed.
It should be noted that surgical intervention is resorted to only as a last resort: after all, surgery cannot eliminate the causes of the disease, but only eliminates its consequences. Prevention will help prevent relapse of the disease. Treatment with traditional methods can last up to six weeks.
The goal of every doctor is to establish the exact cause of the development of the disease in order to select the correct treatment and eliminate what caused the disease to arise and progress. When several factors combine, it can be difficult, especially if they are uncontrollable. When dealing with heel spurs, all means are good.
What are the causes of heel spurs? How can you protect yourself from the onset or progression of plantar fasciitis? Who is at risk for developing spurs?
The causes of heel pain vary - from simple inflammation of all surrounding tissues to severe foot injury. But what contributes to the development of plantar fasciitis? First of all, this is an excessive load on the foot, as a result of which its arches become flattened. What does it mean?
Man is an upright creature; the main load when walking is experienced not only by the spine, but also by the bones of the lower extremities. They also wear out much faster than others. To reduce the load on the bones of the foot and correctly maintain the balance of the body when walking, there are two arches in this part of the skeleton - longitudinal and transverse. Flattening of the arch for all sorts of reasons gradually leads to additional stress. As a result, the fascia located between the heel tubercle and the bones of the toes (it supports the arch) is subject to trauma, which is the cause of its inflammation. During the day, under constant load, microcracks form on it - this causes pain to a person.
That is, the main reason for the appearance of heel spurs is trauma or excessive pressure on the plantar fascia, which is involved in the formation of the longitudinal arch. These may be physical factors, genetic or congenital causes or abnormalities of the aponeurosis itself (another name for fascia), inflammatory processes in the foot area and other diseases of the lower extremities.
calcification of the plantar fascia at its attachment to the calcaneus
Many factors in the development of plantar fasciitis can be combined under the general name - physical causes. This is the largest and main group of heel spur development. What diseases or processes may be included in this group?
Also, the main reason for the development of plantar fasciitis is the excessive load on the foot due to excess body weight. At the same time, doctors do not specify how much improvement is necessary for the foot to begin to experience discomfort. General recommendations from healthcare professionals for optimal body weight range from 20–25 BMI (body mass index). An additional 5–10 kg will affect your overall well-being and joint function.
What do all the above reasons have in common? As a result of their impact, the foot experiences excessive stress, the arch flattens and degenerative changes begin to occur in the fascia, which ultimately lead to the formation of a heel spur.
What happens if there are several reasons for the development of heel spurs, for example, being overweight and wearing the wrong shoes? In this case, the disease develops and progresses much faster.
Injuries are an acute but temporary condition, not everyone wears high heels, and excess body weight often appears over the years. At the same time, young people also feel pain in the heel area, and changes appear on X-ray images indicating the presence of a heel spur. What reasons lead to inflammation of the fascia in such cases? - These are diseases of other organs or tissues.
Another reason is poor circulation of the lower limb and all the diseases associated with it: varicose veins, leading to impaired blood flow, swelling of the legs; atherosclerosis of the arteries of the lower extremities (narrowing of blood vessels due to unhealthy lifestyle - smoking, eating too fatty foods).
Other little-known reasons for the formation of heel spurs include metabolic disorders in the body, hereditary factors, or congenital abnormalities of the skeletal development of the foot area. In each case, the mechanism of the disease is slightly different.
Gout develops more often in men; the disease is characterized by metabolic disorders, due to which uric acid is deposited in the joints of the lower extremities. Not only the joints of the first toe become inflamed, but also the arch of the foot, which will subsequently affect the plantar fascia.
Any profession leaves its own special imprint on a person. But now we will not talk about character traits or behavior, but about those people who have an additional risk of developing plantar fasciitis. What professions contribute to the development of heel spurs?
To summarize, we recall that the cause of heel spurs is excessive load on the plantar fascia, which appears as a result of diseases (mainly flat feet), excess weight, injuries, wearing the wrong shoes, and work associated with prolonged standing. In this regard, it is easy to calculate the predisposition to the development of the disease and try to avoid it. In addition, by removing the cause of the development of heel spurs, we can confidently say that the treatment will be more effective. And if the disease cannot be avoided due to the profession, then it is possible to try to minimize its manifestations by strengthening the fascia. This is the type of disease in the outcome of which not only timely treatment is important, but also the elimination of its main cause.
Plantar fasciitis is a disease characterized by heel pain that is caused by inflammatory and degenerative changes in the plantar fascia. It is possible that the appearance of pain is associated with trauma to the soft tissues surrounding the heel bone and bone growth. Very often this disease is called a heel spur.
The disease most often occurs in people over 40 years of age, and men are less likely to suffer from this disease. Patients who are overweight, suffer from arthritis, diseases of large joints, gout, and flat feet are predisposed to this disease. Also, the risk group for the development of this disease includes athletes who constantly place stress on the foot area. This mostly applies to track and field athletes. With flat feet, the ability to properly distribute the weight of the entire body over the surface of the foot is impaired. As the layer of subcutaneous fat develops, the pain in the heel increases, since this layer is a natural shock absorber for a person when walking.
The very first symptom that is characteristic of this disease is the appearance of pain in the heel, especially intensifying in the morning, when supporting the heel. This symptom is also called “starting pain.” During the day, severe pain gradually fades away, but reappears in the evening. This disease is characterized by burning, sharp pain, which many patients compare to the “feeling of a nail in the heel.” Trying not to overload the sore leg, and fearing pain, a person’s gait changes. If both legs are affected by this disease, walking becomes very difficult. The center of gravity is transferred from the heel area to the front areas and the outer edges of the foot. This often leads to the development of transverse flatfoot. When pressing on the heel tubercle or when squeezing the heel on both sides, severe pain appears. No visual changes are observed.
Anamnesis is studied, complaints characteristic of the disease are taken into account, and radiography is prescribed, which will accurately determine the presence or absence of a heel spur. Since there may be complaints of pain in the heel area, if absent. Thus, differentiation is made with diseases such as rheumatoid arthritis, Reiter's syndrome, which are also characterized by painful symptoms of fasciitis in the heel.
When prescribing treatment, the need to ensure unloading of the heel is taken into account. For these purposes, special insoles and heels are used. Also, a set of physiotherapeutic procedures is prescribed that help eliminate inflammatory processes in the soft tissues near the heel, as well as those aimed at softening the spur itself. Most often they resort to low-intensity laser therapy, radiotherapy, mud applications and mineral baths. Local administration of corticosteroids, such as diprospan and flosterone, has a good effect. If it has reached a sufficiently large size, then shock wave therapy is prescribed, in which the bone growth is affected by sound wave energy. Thus, this growth is destroyed. If the desired effect cannot be achieved, then they resort to surgical treatment, in which the bone outgrowth is removed, and the altered tissue is excised.
In order to prevent the formation of heel spurs, it is necessary to take measures that will prevent the development of inflammation in the soft tissues of the feet and prevent the development of flat feet.
If you are bothered by pain that appears in the heel area, this is not a 100% indicator of the presence of the disease. Only a surgeon or orthopedist can make an accurate diagnosis. Characteristic of this disease are pain in the heel area, which appears in the morning, immediately upon getting out of bed. The pain can be very strong and sharp, many patients characterize it as a “nail driven into the heel.” However, there are diseases in which the nature of pain is similar.
This disease requires mandatory comprehensive treatment, since in 25% of cases, this disease, if left untreated, leads to loss of partial mobility. When making such a diagnosis, the doctor prescribes strict bed rest, or the most gentle working conditions. In any case, patients with heel spurs cannot maintain their usual routine. Often this disease affects athletes who, after diagnosis, are forced to stop intense sports activities.
— A neuroma, which is a benign tumor of nerve fibers or cells, may form.
— Prolonged healing of postoperative wounds is possible, and infectious lesions of wounds are also possible.
— There may be a long process of returning to normal levels of physical activity.
- Very rarely, significant worsening of the symptoms of the disease is possible after surgery.
- Nerve damage or tarsal tunnel syndrome may develop.
Currently, the treatment for heel spurs consists of the complex use of various types of therapy:
To treat heel spurs with folk remedies, a fairly long treatment period of two to eight weeks will be required.