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Heel Spurs: The Cause and Treatment

Heel Spurs: The Cause and Treatment

Have you been told that you have a heel spur?  Sounds painful.  Have you seen a heel spur on x-ray?  Looks even more painful.  Surprisingly however, the bone spur in-an-of-itself is not usually what is causing the heel pain.

The heel spur occurs where the plantar fascia attaches to the heel.  The bottom of the foot is called the plantar surface of the foot.  Fascia refers to a strong fibrous band of tissue, similar to a ligament.  When this area of attachment of the plantar fascia to the heel becomes inflamed it is a condition known as plantar fasciitis.  The term “itis” refers to inflammation.  For instance, appendicitis is inflammation of the appendix, fasciitis is inflammation of the fascia.

The plantar fascia becomes inflamed if the foot pronates or rolls over too much and stretches out the plantar fascia too much.  The plantar fascia actually starts to pulls away from the bone and this is what causes the pain. One way that the body protects itself against this pulling away from the bone is to build up more bone in that area. The resulting build-up of bone is called a bone spur. A bone spur in-and-of-itself sounds painful but usually it is not what is causing the pain.  The heel pain associated with plantar fasciitis comes from the tearing away of the fascia from the bone and not the bone spur itself.

The treatment for heel pain due to plantar fasciitis is a two fold process.  You have to heal the inflamed tissue where the plantar fascia attaches to the heel.  As the inflamed tissue is healing it is important to also correct the problem that initially caused the plantar fasciitis and the heel pain.

The healing of the inflamed plantar fascia is accomplished by healing the inflamed tissue and correcting the cause. First of all you should start some type of anti-inflammatory medication such as ibuprofen. Acetaminophen may reduce pain but does not have anti-inflammatory properties.  Applying ice to the heel will also reduce some of the inflammation. In addition some doctors prescribe what is called a dorsal night splint to heal the plantar fascia.  The dorsal night splint is worn on the lower leg at night.  The idea is to use the splint to hold the foot slightly flexed up toward your head as you sleep.  This allows the plantar fascia to heal in a stretched out position so that the first steps in the morning do not break away the newly healed tissue.

As the plantar fascia begins healing it is essential that the problem which caused the heel pain is corrected.  Most heel pain is the result of a biomechanical problem that causes excessive pronation (excessive flattening of the arch) and thus excessive stretching of the plantar fascia.  The excessive pronation can be corrected with an arch support. The over the counter cushioning devices are helpful to reduce the pain, help calm things down a bit and allow the healing to start but in order to prevent the heel pain from returning you have to correct the faulty biomechanics.  This usually requires a custom arch support.  Custom arch supports will be made to match the exact contour of your foot.  The custom arch support will limit the pronation, reduce stretch on the plantar fascia, reduce the heel pain and allow the heel to heal.

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