Do you have a sharp pain in your heel when you get out of bed in the morning? When you take a step, does it feel like someone is jabbing a knife in your heel? If so, you might have a heel spur.
A heel spur is a degenerative outgrowth of bone on the calcaneus. While the heel spur itself is sometimes painless, the condition is commonly associated with Plantar Fasciitis.
When there is an increase in tensile stress on the fascia under the longitudinal arch, a low-grade inflammation develops at the point of attachment on the calcaneus.1 If the increased stress and inflammation continues, calcium is deposited, and a bony outcropping builds up.
Studies suggest that heel spurs themselves are not what causes pain; rather, spurs occur in 50-75% of heels afflicted with painful plantar fasciitis,2 (though they have also been found in up to 63% of asymptomatic heels).3 Those who suffer from heel spurs often report a sharp pain in the heel, which may radiate to the bottom of the foot.
Symptoms can interfere significantly with walking, especially with the first steps out of bed in the morning. Palpation of the foot will result in pain and tenderness with direct pressure over the medial tubercle of the calcaneus.4
Surgery can be costly, risky, and is rarely necessary. Recovery time—between 3 to 6 months or more to return to weightbearing activities5—can also be a deterrent.
Conservative treatment, on the other hand, is shown to be quite effective. The pain and irritation experienced by at least 90% of people with heel spurs will respond favorably to conservative measures.6
- Frequently stretch foot and calf.
- Icing the heel can help bring down swelling.
- Wear custom orthotics in all shoes.
- Exercises focused on strengthening muscles in the feet and ankles.
- Weight loss, graduated athletic training schedule, better shoes for long-term may be helpful.
At a Chiropractic office:
- Foot adjustments for inferior navicular, fixated cuboid, posterior calcaneus and/or “dropped” metatarsal heads. Though adjustments may help reduce symptoms, they do not restore plantar aponeurosis laxity or the resultant excessive pronation. Three arch support with custom orthotics is essential to support the structural components of the feet when soft tissue components are unable to do so.
- Custom orthotics with support for all 3 arches help control pronation and protect against damaging heel shock, which of course will help reduce your heel pain.
- Your healthcare provider and custom orthotic manufacturer can offer a special cut out (a “divot”) at the site of the insertion of the plantar fascia to reduce pressure.
Pain from heel spurs can be reduced and/or controlled by taking the movement patterns of the foot and ankle into account. Custom orthotics can improve your current symptoms and help prevent future difficulties and deterioration. Though there is no “cure” for heel spurs, specific foot adjustments, along with home stretching, and weight loss can also be helpful.
1 Hertling D, Kessler RM. Management of Common Musculoskeletal Disorders 2nd ed. Philadelphia: JB Lippincott 1990:400.
2 Kibler WB et al. Functional biomechanical deficits in running athletes with plantar fasciitis. Am J Sports Med 1991; 19:66-71.
3 Jahss MH et al. Investigations into the fat pads of the sole of the foot. Foot & Ankle 1992; 13:233-242.
4 Souza TA. Differential Diagnosis for the Chiropractor. Gaithersburg: Aspen Pubs 1997:354.
5 Horn LM. Surgical intervention. In: Subotnick SI, ed. Sports Medicine for the Lower Extremity. New York: Churchill Livingstone 1989:472.
6 Contompasis JP. Surgical treatment of calcaneal spurs: a three year post-surgical study. J Am Pod Med Assoc 1974; 12:987-999.