The heel bone forms one end of the longitudinal arch of the foot.

A heel spur results from excessive traction or pulling by the tendons or ligaments on their insertion points on the heel bone. The inflammation that results from this stimulates the heel bone to grow a spur at this point. It appears that the body grows this spur in an attempt to decrease the pulling forces by growing out to meet the tendon or ligament.

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The calcaneal spur is most often found in persons over the age of 40. This condition is often associated with poor circulation, osteoarthritis, rheumatoid arthritis and other degenerative diseases. Heel spurs occur equally in men and women.

On X-ray examination, the spur can resemble a protruding tooth or spike penetrating the flesh of the heel.

Considerable pain and suffering is caused by heel spurs. It can take years between the formation of the spur and the development of symptoms. The spur is a source of continual painful aching. It is often referred to as “toothache in the feet”. Weight placed on the heels spur can cause sufficient pain to immobilize the patient.

Pain is not in actual fact caused by pressure on the spur. It results from inflammation around the tendons where they attach to the heel bone. For this reason, pain is at its most severe when the patient starts to walk after a period of rest or when getting out of bed in the morning.

The pain actually decreases as you walk on the spur once the tendons and ligaments have warmed up. The nerves and capillaries around the spur then adapt themselves to the situation. After a period of rest, the nerves and capillaries have to re-adapt to the spur again. Pain is always more severe after a day of excessive strain being placed on the spur.

Treatment of bonespurs

• Stretching the calf muscles twice a day for 30 seconds will reduce the pulling on the area, reducing the symptoms of the spur.
• A custom-made orthotic insert will support the medial arch of the foot and transfer the weight toward the front of the foot, away from the spur and protect the non-affected foot. Wearing a well cushioned shoe will aid the orthotic device in supporting the foot.
• Physiotherapy is very useful in treating calcaneal spurs, using a variety of therapies.
• Applying an ice pack to the affected area for 10 minutes at night or alternatively using ice and gentle heat therapy may also alleviate the symptoms.
• Cortisone may be injected into the area around the spur. This is a painful experience that can relieve symptoms for a period of time, usually a couple of months. This is not a cure and symptoms will eventually return.
• The heel spur can also be surgically removed.

(Written by Dallas Fell and Chris Delpierre, registered podiatrists with the H.P.C.S.A)

South African Podiatry Association (SAPA)
 

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