(plantar spur, plantar fasciitis)
A heel spur is a pointed conglomerate on the heel, which is directed towards the toes and puts pressure on the soft tissues of the foot. Spurs may appear on one or both heels. This disease affects people of any age, and out of 100 cases, 80 are women.
Sharp pain in the heel occurs in the morning after the beginning of the load on the foot. Around noon its intensity decreases, but by evening it returns with the same strength. There may be sharp pain when resting on the heel, which occurs for no apparent reason. All patients with this disease change their gait.
Diagnosis is carried out taking into account anamnesis, examination and palpation of the foot area. An X-ray examination is performed. At the initial stage of the disease, it is not informative, so it is advisable to supplement it with ultrasound scanning.
Treatment begins with the use of special orthopedic insoles and heel supports that redistribute the load on the bones of the foot. Drug treatment is aimed at relieving pain and inflammation. Physiotherapeutic techniques, exercise therapy and massage are used. You can try to destroy the spur with laser radiation or using x-ray therapy. However, these techniques mainly affect the inflamed surrounding soft tissues, relieve pain, but are not able to radically help. Surgical removal of heel spurs is undertaken only if preventive and conservative treatment measures are ineffective.
There are contraindications. Specialist consultation is required.
When treating heel spurs, compresses with dimexide solution are used. The solution is obtained by mixing 1 tablespoon of the drug and 3 tablespoons of boiled water. The drug is used for at least one week. According to doctors' recommendations, the course of treatment should be about one month. Compresses with demethyl sulfoxide are applied to the heel spur for 20-30 minutes. In order for the active substance to penetrate better to the site of the disease, wear a warm sock. Absorption of the substance occurs faster as the temperature rises.
The drug effectively eliminates the symptoms of heel spurs after a single local administration in a dose of 0.5 ml.
Consultations with a surgeon, orthopedist and rheumatologist are recommended.
No one is immune from heel spurs. This problem develops gradually, but manifests itself quickly with sharp, piercing pain. The disease is more common in people over 40, but young athletes can also fall victim to plantar fasciitis. Therefore, everyone needs to know about the disease. What are the symptoms of a heel spur? Why does it develop? Is it difficult to treat the disease, and what are its consequences?
It is impossible to understand what a heel spur is without knowledge of the anatomy of the foot and its ligamentous apparatus. The foot is considered a complex organ. It is formed by 26 bones and 33 joints. The bone apparatus is connected by muscles and ligaments. The foot muscles must be very strong and powerful because they support the entire weight of the human body.
The longest ligament in the foot is called the plantar fascia or plantar aponeurosis. This is an inelastic, dense formation that supports the arch of the foot. The fascia originates from the heel tubercle and ends almost at the toes. The heaviest load occurs at the site of attachment of the fascia to the heel bone.
What causes spurs on the heels? Because an inflammatory process begins on the fascia, caused by various factors (more on them later). At first it is painless, so the person does not pay attention to the slight feeling of discomfort in the foot. Diagnosis of heel spurs at this stage is also complicated by the absence of a growth as such. The realization that plantar fasciitis is developing comes only after poking the heel.
Let's start with the main thing. Let’s look at the symptoms of spurs on the heels so that we can understand what it is.
These are all signs of the disease. There are not so many of them that a person can accurately determine that it is a spur. It can easily be confused with a callus on the heel, a crack or a broken bone. Therefore, you should not diagnose the disease yourself. You need to see a doctor.
Those who have had or have a heel spur compare the feeling of it to a nail or pushpin in the heel. A man takes a step and involuntarily withdraws his leg from acute pain. He thinks he stepped on a small object. But there is nothing on the heel and on the floor. This is a spur that forms on the heel bone in the form of a process.
It all starts with plantar fasciitis. This is the name for inflammation of the fascia - the connective tissue of the sole, located near the heel tubercle and reaching the toes. If the inflammatory process is not stopped by anything, calcification will begin: the inflamed area is saturated with calcium salts, which grow and form a spine-shaped osteophyte. It doesn't hurt, but it puts a lot of pressure on soft tissues when walking. This is how heel spurs form.
Many people want to know what a heel spur looks like. But outwardly she does not manifest herself in any way. We described the only external symptom earlier: the heel may turn red and swell after a working day. But these are not specific signs of heel spurs.
You can find out what a spur on a leg looks like from the inside in medical reference books or textbooks. If you imagine the heel bone, then the spur is a small spine-like process located almost perpendicular to the surface of the earth. When walking, a person seems to step on something sharp, hidden in his own heel.
Knowing why heel spurs occur can help prevent them.
The following categories of people are at risk:
There are also additional reasons for the appearance of heel spurs. These are: poor nutrition, weak muscles and ligaments due to low physical activity. All together, this gradually gives rise to the development of fasciitis, and then the formation of a spur. The hereditary cause of heel spurs has not been established.
When a heel spur occurs, a person does not even know which doctor to see. In such cases, you can start with a therapist, but this is a waste of time. Heel spurs on the feet can be treated immediately by a surgeon, traumatologist or rheumatologist. It is ideal if you find a specialist qualified as an orthopedic surgeon. He knows exactly all the structural features of the heel bone, so he can correctly diagnose the disease, determine the stage of development and prescribe productive treatment.
A massage therapist can also treat a spur on the leg, but a specialist must be referred to him. Regular and proper foot massage will help relieve pain, eliminate congestion, develop the muscular-ligamentous system and remove salts.
It wouldn’t be a bad idea to visit a physical therapy (therapeutic physical education) instructor. This doctor will teach you how to distribute your weight while walking so that it doesn’t hurt and doesn’t cause flat feet. The physical therapy specialist will also show you some simple exercises to strengthen the muscles of your lower leg and foot, so that you can more easily deal with spurs.
Treatment for a spur boils down to relieving the pain that torments a person all day. By night the pain subsides because the feet are at rest. In the morning, the nightmare begins: a sharp spur is stuck into the muscles that were relaxed during the night, which could increase in size during the night. It takes a lot of time and patience to disperse, so a person most often prefers to immediately take a painkiller pill.
By the way! Some people, knowing what awaits them when they put their feet on the floor, take the pill in advance. Then they rest in bed for another half hour so that the analgesic has time to take effect, and only then get up. Such “treatment” cannot be practiced too often, otherwise the body will get used to the medications and they will stop working.
But pain with a heel spur occurs not only in the morning, but also after several minutes of rest. Those. you can sit down to watch a TV show, get up half an hour later and again feel an invisible hot nail digging into your heel. People with a low pain threshold or stage 1 heel spur may not experience as much pain, but heel spur treatment is still necessary.
There is another type of pain with a heel spur, which appears in the evening. Fatigue accumulates throughout the day, and sore muscles begin to ache. Those. you can just sit with your legs stretched out, and you can feel the pulsation in your feet.
What to do if your heel spur hurts? We have already decided that you should take painkillers only in extreme cases, when there is no way to relieve the pain in other ways. Which ones?
There are no special pills against heel spurs. But there are medications that have anti-inflammatory and analgesic properties. These are Ibuprofen, Indometatsi, Ketoprofen, etc. Taken in courses as part of complex therapy. A doctor must prescribe the pills.
External methods of treating heel spurs necessarily involve the use of ointments and compresses for the feet. Recipes for them can be found on the Internet among folk remedies. The second option: buy ready-made ointments at the pharmacy.
The effectiveness of using external agents for heel spurs comes down to the following effects:
Ointments against heel spurs can be hormonal and non-hormonal. Medicines from the first category must be prescribed by a doctor, because they have many side effects and contraindications. Non-steroidal ointments can be purchased and used at home yourself. Their range is very wide.
Warming baths with medicinal herbs will soothe aching and paroxysmal pain and additionally steam the leg. The second factor is also important, because the next step after the bath is usually the application of an ointment or compress.
How to treat heel spurs using baths? Very simple. Every day before going to bed, do procedures that will be pleasant and useful.
This treatment for heel spurs is auxiliary. Baths alone will not cure plantar fasciitis.
Necessary for weight distribution across the foot and heel cushioning. Such devices are especially relevant for those who have developed heel spurs due to wearing uncomfortable shoes or due to flat feet.
Orthopedic shoes for heel spurs are not a luxury, but a necessity. Special boots with a comfortable last and insoles solve several problems at once:
It does not matter what stage of development the spur on the foot has reached. Orthopedic shoes will always be relevant, including for prevention.
A unique invention that allows you to immobilize the foot, keeping it in a position at right angles to the shin. This provides support to the plantar fascia, allowing micro-tears to heal without impacting the soft tissue.
To prevent the spur on the foot from hurting so much when walking and from growing, you need to use orthopedic insoles in the form of heel pads. They are made of special gel and latex, and are very soft to the touch, but elastic. The heel support puts the heel in the anatomically correct position and not only reduces pain, but also reduces the load when walking.
Exercises help develop the muscular-ligamentous apparatus of the lower leg and foot, which helps resist the disease. After all, one of the reasons for the formation of spurs, as has already been found out, is low physical activity and weak leg muscles. A set of exercises is selected by a physical therapy specialist.
Physiotherapy is an effective method of treating heel spurs. Due to the effect of currents, vibrations or other radiation on the source of inflammation, pain is relieved, blood circulation is improved, and cells of the affected soft tissues are regenerated.
Physiotherapy for heel spurs can be performed in a clinic or at home. In the second case, you will have to buy one of the devices (Almag, Vitafon, Darsonval).
Surgery for spurs is a rare occurrence because it is performed only in critical conditions. But it’s difficult to launch a spur, because... she reminds herself of herself every day with acute pain. However, sometimes a person still ends up on the operating table.
Previously, surgical treatment was carried out exactly this way: the heel was cut with a scalpel and the heel spur was removed with instruments. Nowadays, such operations are almost never performed due to the high morbidity and long recovery period.
A more modern method of treating heel spurs using endoscopic equipment. The surgeon just needs to make a couple of small incisions: through one, a camera is inserted, and through the other, an instrument that will be used to remove the spur.
This operation involves completely excising the fascia of the sole. Thanks to this, the tension in it is reduced. After this, the spur itself is cut off with a milling cutter.
Surgical treatment is also possible using minimally invasive technology. The number of cuts is half as much as in the previous method: only one. And its size is also significantly smaller. An X-ray tube is inserted inside, which easily detects the pathological growth. The place is fixed with a special cannula, after which the cutter is again inserted inside.
The heel heals much faster after such an operation. Complications are also kept to a minimum. And if the patient follows all the doctor’s instructions, then after a couple of months he will be able to run.
This is a mandatory point, regardless of which intervention method was used. The patient is instructed not to put any weight on the operated leg. At first you will have to use crutches, then orthopedic shoes or insoles are required.
If plantar fasciitis is left untreated and left untreated, it will result in partial loss of mobility. Sooner or later, the pain can become so unbearable that a person will not be able to walk, even leaning on his toes.
Chronic inflammation of the heel spur also does not bode well. This can provoke intramuscular suppuration. You will have to do an emergency operation, which will be dangerous due to complications due to the risk of infection.
Another danger that a spur on the sole can cause is a neuroma - a benign tumor formed from nerve fibers. It will hurt even more even at rest. It cannot be treated conservatively. Only surgery.
Diet is an unspoken method in the treatment of any disease. In general, you should always eat right, but if you can’t do this, then you need to change your diet at least during the activation of the disease.
Nutrition for heel spurs should, first of all, be complete. Fasting or a strict diet is not allowed, despite the fact that losing weight will not hurt. The daily energy value of everything eaten should be at least 2500 kcal.
Principles of nutrition for heel spurs:
The diet for heel spurs has no strict prohibitions. It is quite possible to replace smoked meats and pickles with products that are safer for health. And from the abundance of vegetables, lean fish and soups, no one felt worse. Proper nutrition is an excellent prevention of not only heel spurs, but also other diseases.
Even the most effective heel spur treatment or surgery does not provide a 100% guarantee that the spur will not return. Osteophytes can form again and again, so prevention should be taken. The main thing that a person can do is start wearing high-quality or specialized shoes and switch to proper nutrition. It would not be superfluous to use ointments for the heel, because a warming massage has a beneficial effect on soft tissues and prevents salt deposition. People who are rapidly gaining weight should be especially careful. Due to increased stress, heel spurs can develop very quickly.
And remember: instead of diagnosing yourself, much less prescribing treatment, you should consult a doctor. Only a specialist will be able to determine whether it is plantar fasciitis or not. He will also tell you how to treat heel spurs in your case.