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Heel spurs, also known as calcaneal spurs, are bony extensions that develop on the bottom or back of the heel bone (calcaneus). They typically form where the plantar fascia (a thick band of tissue running across the bottom of the foot) and the Achilles tendon attach to the heel bone. Heel spurs usually do not cause symptoms unless they are large. More commonly, heel pain is associated with underlying conditions affecting the structures connected to the heel, such as plantar fasciitis and Achilles tendonitis.
The photo above shows the most common locations where spurs usually develop: a plantar (bottom) spur, where the plantar fascia attaches, and a dorsal (back of heel) spur, where the Achilles tendon inserts.
Causes of Heel Spurs
Heel spurs are the body's way of reacting to stress and strain from the foot's ligaments and tendons. For instance, the Achilles tendon, which attaches to the back of the heel bone, stretches and pulls at its insertion point on the heel. As a result of repetitive stress, heel spurs develop due to calcium deposits forming at the site where the tendon attaches to the bone.
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Risk Factors of Heel Spurs
Repetitive Stress: Activities that involve repetitive stress on the heel, such as running, dancing, or prolonged standing, can contribute to the development of heel spurs.
Tight Structures at Heel Insertion: Tightness in the plantar fascia or calf muscles increases traction at the attachment point of the heel.
Flat Feet or High Arches: Abnormalities in foot structure, such as flat feet (overpronation) or high arches, can place extra strain on the heel and contribute to the formation of heel spurs.
Poor Footwear: Wearing shoes that lack proper support or cushioning can increase the risk of heel spurs. High heels or shoes with inadequate arch support can also be problematic.
Obesity: Excess body weight puts additional stress on the feet, particularly on the heel, which can contribute to the development of heel spurs.
Medical Conditions: Certain conditions, such as ankylosing spondylitis or rheumatoid arthritis, can increase the risk of developing heel spurs.
Treatment and Management of Heel Spurs
When treating heel spurs, it's crucial to identify the underlying cause of the pain. Often, symptoms may stem from conditions such as plantar fasciitis or Achilles tendonitis, rather than from issues with the heel bone itself.
Treatment and management of heel spurs include:
Lower limb stretching and strengthening exercises: To stretch tight plantar fascial band and Achilles tendon; as well as strengthening the lower leg muscles.
Well-cushioned, supportive footwear: To reduce pressure on the heel.
Custom Foot Orthotics: To provide additional support, cushioning, and redistribution of pressure.
Extracorporeal Shockwave Therapy (ESWT): This non-invasive procedure uses shockwaves to stimulate healing, reduce surrounding inflammation and pain in chronic cases.
Surgery: Surgical removal of a heel spur is considered only if it is determined to be the main source of heel pain. It is generally a last resort after other treatments have been exhausted.
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