A calcaneal spur (or heel spur) is a small osteophyte (bone spur) located on the calcaneus (heel bone). Calcaneal spurs are typically detected by a radiological examination (X-ray). When a foot bone
is exposed to constant stress, calcium deposits build up on the bottom of the heel bone. Generally, this has no effect on a person's daily life. However, repeated damage can cause these deposits to
pile up on each other,causing a spur-shaped deformity, called a calcaneal (or heel) spur. Obese people, flatfooted people, and women who constantly wear high-heeled shoes are most susceptible to heel
spurs. An inferior calcaneal spur is located on the inferior aspect of the calcaneus and is typically a response to plantar fasciitis over a period, but may also be associated with ankylosing
spondylitis (typically in children). A posterior calcaneal spur develops on the back of the heel at the insertion of the Achilles tendon. An inferior calcaneal spur consists of a calcification of the
calcaneus, which lies superior to the plantar fascia at the insertion of the plantar fascia. A posterior calcaneal spur is often large and palpable through the skin and may need to be removed as part
of the treatment of insertional Achilles tendonitis. These are also generally visible to the naked eye.
An individual with the lower legs angulating inward, a condition called genu valgum or "knock knees," can have a tendency toward excessive pronation. As a result, this too can lead to a fallen arch
resulting in plantar fascitis and heel spurs. Women tend to have more genu valgum than men do. Heel spurs can also result from an abnormally high arch. Other factors leading to heel spurs include a
sudden increase in daily activities, an increase in weight, or a change of shoes. Dramatic increase in training intensity or duration may cause plantar fascitis. Shoes that are too flexible in the
middle of the arch or shoes that bend before the toe joints will cause an increase in tension in the plantar fascia and possibly lead to heel spurs.
Most of the time heel spurs present as pain in the region surrounding the spur, which typically increases in intensity after prolonged periods of rest. Patients may not be able to bear weight on the
afflicted heel comfortably. Running, walking, or lifting heavy weight may exacerbate the issue.
Because the diagnosis of heel spurs can be confused with tarsal tunnel syndrome (as described earlier), most surgeons advocate performing a tarsal tunnel release (or at least a partial tarsal tunnel
release) along with the plantar fascia release. This surgery is about 80percent successful in relieving pain in the small group of patients who do not improve with conservative treatments.
Non Surgical Treatment
Since heel spurs are not an indication of pain themselves unless fractured, treatment is usually aimed at the cause of the pain which in many cases is plantar fasciosis. Treatment of plantar
fasciiosis includes; rest until the pain subsides, special stretching exercises and if required orthotics may be prescribed.
Most studies indicate that 95% of those afflicted with heel spurs are able to relieve their heel pain with nonsurgical treatments. If you are one of the few people whose symptoms don?t improve with
other treatments, your doctor may recommend plantar fascia release surgery. Plantar fascia release involves cutting part of the plantar fascia ligament in order to release the tension and relieve the
inflammation of the ligament. Sometimes the bone spur is also removed, if there is a large spur (remember that the bone spur is rarely a cause of pain. Overall, the success rate of surgical release
is 70 to 90 percent in patients with heel spurs. One should always be sure to understand all the risks associated with any surgery they are considering.