A heel spur is a bony segment of calcium deposit that grows on the underside of a person's heel. Typically, a heel spur causes no pain and does not grow unless severe tension occurs on the plantar fascia ligament, which connects the muscles on the bottom of the foot. When this ligament stretches, which can be caused by overexertion or from an increased amount of weight being placed on it, it can become swollen. This condition is called plantar fasciitis and requires medical care.
In 70% of plantar fasciitis cases, a heel spur is evident. When plantar fasciitis sets in, the bony protrusion of the heel spur pokes into the swollen ligament, which is why many people believe heel spurs and plantar fasciitis are closely linked. In reality, they are two separate conditions. A heel spur alone never causes pain until the plantar fascia ligament becomes swollen.
Typically, plantar fasciitis is treated with rest, ice packs, and muscle rubs. Once the condition is reversed, doctors recommend purchasing shoes containing good arch support and adding heel pads to footwear to prevent recurrence. Losing excess weight and doing calf stretches before partaking in rigorous activity can also prevent heel spurs. For some, it is also necessary to wrap the feet in tape before playing sports. Most cases of heel spurs and plantar fasciitis do not recur if these directions are followed carefully.
In some extreme cases, surgery is required to get rid of heel spurs and plantar fasciitis. During a surgery for plantar fasciitis, the bone spur is trimmed down and the plantar fascia is cut and reattached to the heel. Unfortunately, plantar fasciitis and heel spur problems actually increase in 50% of patients after surgery. In addition, this surgery can create nerve damage and fallen arches, which leads to additional pain.
A newer procedure for treating heel spurs, Endoscopic Plantar Fasciotomy, involves making two small half-inch incisions into the heel. The plantar fascia is then slit, which relieves the pain. In a few days, the plantar fascia generates new tissue and repairs the slit. Few doctors are accustomed to this procedure, making it difficult for many patients to find qualified Endoscopic Plantar Fasciotomy surgeons.