When someone has heel pain, this is a common assumption that this type of pain is caused by a heel spur. A heel spur is a foot condition which is created by a bony – like growth that is called calcium deposit and it extends between the arch and heel bone. The heal spurs often start in the front of our heel and eventually it affect other parts of our foot. They are normally about a quarter of inch in length so they may not be visible with naked eye. Detecting this condition, heel spurs, can be challenging. This condition does not always cause pain and not all heel pain is related to heel spurs.
Symptoms of heel spurs
Symptoms of the heel spurs can include swelling, inflammation and pain at the front of your heel. Also the affected area can be warm to the touch. The symptoms of heel spurs can spread to the arch of your foot. If there is a small bony protrusion, then it can be visible. There are some heel spurs which do not cause symptoms at all. About 50% of people who have heel spurs experience pain from time to time [1]. Also you may not see changes in the bones surrounding the heel or in soft tissues surrounding your heel. In the most cases heel spurs are often discovered through X – rays and other tests which are done for another foot ailment. It is very difficult to diagnose a heel spur on your own. This is because the symptoms of heel spurs are similar to other forms of foot problems and heel pain. You need to see a specialist such as a podiatrist or orthopedic surgeon because he or she will tell you the proper diagnosis for your condition. This specialist will detect the heel spur through an X – ray. Many people who have pain caused by heel spurs and plantar fasciitis are describing that it feels like a pin or knife sticking into the bottom of their feet when the first stand up in the morning and this pain later turns into a dull ache. Also these people often complain that the sharp pain returns after they stand up after sitting up for a prolonged period. Heel spurs are treated by measures which can decrease the inflammation which is associated with this condition and to avoid re-injury. There are some cases when heel spurs happen alone but on the other hand there are bone spurs which are related to underlying diseases. Heel spurs which are under the sole of your foot, the plantar area, are associated with the plantar fasciitis [2].
Causes of heel spurs
This condition is caused by long – term ligament and muscle strain. Eventually, this excessive strain can stretch the soft tissues in your heel and it can wear them out. You should know that the heel spurs are developing over time. They do not suddenly appear after a sports event or a workout. This condition also tends to happen when you ignore symptoms like heel pain. The most common cause for heel spurs is the repetitive stress from jumping, running or walking. Also heel spurs can develop from wearing shoes that do not support your foot. Heel spurs can also be caused by:
- Worn – out shoes
- Wearing flip – flops too often [3]
- Walking gait issues
- Poorly fitted shoes [4]
- Excess body weight [5]
- Bruising of the heel
- Arthritis
There are some studies in which is said that more than half of all cases of heel spurs happen in people who also suffer from plantar fasciitis [1]. This is a painful condition which deals with the tough and fibrous tissue that is running between your heel and toes. This means that if you have plantar fasciitis, then this can increase your risk of developing heel spurs.
Risk factors: Here are some factors which are increasing your risk of heel spurs:
- Excess weight and obesity [5]
- Poorly fitted or badly worn shoes, especially those lacking appropriate arch support [4]
- Running or jogging, especially on hard surfaces
- Walking gait abnormalities, which place excessive stress on the heel bone, ligaments and nerves near the heel
Also there are other risk factors which are associated with plantar fasciitis and they include:
- Having either flat feet or high arches [3]
- Frequent short bursts of physical activity
- Spending most of the day on one’s feet
- Diabetes [6]
- Increasing age, which decreases plantar fascia flexibility and thins the heel’s protective fat pad
References:
[1] Harvard Women’s Health Watch. Easing the pain of plantar fasciitis. Harvard Health Publishing. 2007. Retrieved from www.health.harvard.edu/newsletter_article/easing_the_pain_of_plantar_fasciitis
[2] Zhang L, Cheng H, Xiong L, et al. The relationship between calcaneal spur type and plantar fasciitis in Chinese population. BioMed Research International. 2020.
[3] Wibowo DB, Harahap R, Widodo A, et al. The effectiveness of raising the heel height of shoes to reduce heel pain in patients with calcaneal spurs. Journal of Physical Therapy Science. 2017;29(12):2068–74.
[4] Buldt AK, Menz HB. Incorrectly fitted footwear, foot pain and foot disorders: a systematic search and narrative review of the literature. Journal of Foot and Ankle Research. 2018;11:43.
[5] Irving DB, Cook JL, Young MA, Menz HB. Obesity and pronated foot type may increase the risk of chronic plantar heel pain: a matched case-control study. BMC Musculoskeletal Disorders. 2007;8:41.
[6] Gariani K, Waibel FWA, Viehofer AF, Uckay I. Plantar fasciitis in diabetic foot patients: Risk factors, pathophysiology, diagnosis, and management. Diabetes Metabolic Syndrome and Obesity. 2020;13:1271–9.
