Although many people with plantar fasciitis have heel spurs, spurs are not the cause of plantar fasciitis pain. One out of 10 people has heel spurs, but only 1 out of 20 people (5%) with heel spurs has foot pain. Because the spur is not the cause of plantar fasciitis, the pain can be treated without removing the spur.
Heel spurs develop as an abnormal growth in the heel bone due to calcium deposits that form when the plantar fascia pulls away from the heel. This stretching of the plantar fascia is usually the result of over-pronation (flat feet), but people with unusually high arches (pes cavus) can also develop heel spurs. Women have a significantly higher incidence of heel spurs due to the types of footwear often worn on a regular basis.
Most heel spurs cause no symptoms and may go undetected for years. If they cause no pain or discomfort, they require no treatment. Occasionally, a bone spur will break off from the larger bone, becoming a ?loose body?, floating in a joint or embedding itself in the lining of the joint. This can cause pain and intermittent locking of the joint. In the case of heel spurs, sharp pain and discomfort is felt on the bottom of the foot or heel.
The diagnosis of heel pain and heel spurs is made by a through history of the course of the condition and by physical exam. Weight bearing x-rays are useful in determining if a heel spur is present and to rule out rare causes of heel pain such as a stress fracture of the heel bone, the presence of bone tumors or evidence of soft tissue damage caused by certain connective tissue disorders.
Non Surgical Treatment
Podiatric Care for heel spur syndrome may involve keeping the fascia stretched out by performing exercises. Your doctor may also suggest for you to be seen by a physical therapist. You probably will be advised on the best shoes to wear or some inserts for your shoes. Your podiatrist may suggest that a custom made orthotic be made to allow your foot to function in the most ideal way especially if you have excessive pronation. A heel lift may be used if you have a leg length discrepancy. Medical treatment may include anti-inflammatory oral medications or an injection of medication and local anesthetic to reduce the swelling and decrease pain. If a bursitis is present the medication may greatly improve the symptoms. Your podiatric physician may also recommend a surgical procedure to actually fix the structural problem of your foot.
Heel spur surgery should only be considered after less invasive treatment methods have been explored and ruled insufficient. The traditional surgical approach to treating heel spurs requires a scalpel cut to the bottom of the food which allows the surgeon to access the bone spur. Endoscopic plantar fasciotomies (EPF) involve one or two small incisions in the foot which allow the surgeon to access and operate on the bone spur endoscopically. Taking a surgical approach to heel spur treatment is a topic to explore with a foot and ankle specialist.