Heel spurs

plantar fascia and heel spur

A heel spur – also known as a calcaneal spur - is a pointed bony outgrowth of the heel bone (calcaneus). Heel spurs do not always cause pain and often are discovered incidentally on X-rays taken for other problems.

Heel spurs can occur at the back of the heel and also under the heel bone on the sole of the foot, where they may be associated with the painful foot condition plantar fasciitis.

What causes heel spurs?

A strong band of sinew (plantar fascia) stretches across the sole of the foot below the surface of the skin and is attached to a point in the middle of the under surface of the heel bone.

With repeated activity on our feet, the plantar fascia can become tight and cause persistent traction (tugging) on its attachment point into the heel bone, and inflammation and pain may develop at this site. This painful condition is known as plantar fasciitis.

Sometimes a ‘spur’ develops at the site of this traction on the bone and protrudes into the surrounding tissue. This is a heel spur.

Treatment

Heel pain may be associated with a heel spur, however the heel pain is usually due to plantar fasciitis, rather than a heel spur, so treatment is usually directed at the plantar fasciitis itself.

Treatment usually involves application of ice to reduce pain and inflammation, special stretching exercises, and pain-relieving or anti-inflammatory medicines. Night splints or orthotics may be recommended. It may help to avoid the activities that aggravate pain, such as long walks and running. Surgery is very rarely recommended and only after other measures fail.

Last Reviewed: 11 February 2013
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References

1. Mayo Clinic. Heel pain. Last reviewed 21 Aug 2010. http://www.mayoclinic.com/health/heel-pain/MY00081 (accessed Feb 2013).
2. Mayo Clinic. Heel spurs: do they always cause pain? http://www.mayoclinic.com/health/heel-spurs/AN01966 (accessed Feb 2013).
3. Mayo Clinic. Plantar fasciitis.Last reviewed 15 March 2011. http://www.mayoclinic.com/health/plantar-fasciitis/DS00508 (accessed Feb 2013).
4. Australian Podiatry Association. Heel pain. http://www.podiatry.asn.au/knowledgebase.asp?pid=15&id=20 (accessed Feb 2013).
5. BMJ. Patient leaflets. Heel pain. Last reviewed 31 Oct 2012. http://bestpractice.bmj.com/best-practice/pdf/patient-summaries/532382.pdf (accessed Feb 2013).
6. MedicineNet.com. Heel spurs and plantar fasciitis. Reviewed 24 July 2012. http://www.medicinenet.com/heel_spurs/article.htm (accessed Feb 2013).
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