A heel spur is a bony protrusion on the underside of the heel bone. It can been seen on an x-ray but might be suspected even before an x-ray is ordered. They are found in a vast majority of people and most times are incidental findings as they do not cause pain, but in some cases they can be painful.
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Symptoms
Where pain is present, it is felt on the underside of the adult heel bone, also known as the calcaneus. It can feel sharp and is mostly bothersome when standing, walking, running or jumping. It does not radiate and is very localized to the bottom of the heel, where the plantar facia ligament attaches to the heel bone.
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Causes
Heel spurs occur when calcium deposit (bone) builds up on the underside of the heel bone, a process that usually occurs over a period of many months or years. Heel spurs are often caused by strains on foot muscles and ligaments, such as stretching of the plantar fascia ligament, and repeated tearing of the membrane that covers the heel bone. Heel spurs are especially common amongst athletes whose activities include large amounts of running and jumping. Other risk factors include obesity and walking or gait abnormalities.
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Treatment
Conservative treatment is the first line therapy approach, which consists of off loading the heel spur. Taking the load off can be accomplished with orthotics that are modified with a “cut out” for the heel spur. Gel heel pads in shoes can offer temporary relief, but are a bandaid solution. Having a pair of orthotics made custom to your walking/gait abnormalities, addresses the causation in addition to relieving pressure and discomfort at the bottom of the heel. Conducting stretches of the calf muscle and plantar fascia are beneficial also. Proper footwear, fit by a Canadian Certified Pedorthist, and avoiding barefoot walking/running are important first steps to healing. Icing the heel after activity can help reduce the acute inflammation. Heel pain is not normal and requires a visit to a Foot care Clinician.
