A heel spur is a thorn-like calcium deposit in the system of tendons and ligaments (plantar fascia) around the heel bone and sole of the foot. The condition is also known as plantar fasciitis. Heel spurs are caused by tiny tears and areas of inflammation in the tendons and ligaments, which lead to a build-up of calcium deposits. Heel spurs can usually be treated conservatively, without an operation.
The tendons and ligaments that run along the inside of the sole of the foot are attached to the heel bone (calcaneus). This structure is known as the plantar fascia. If these tendons and ligaments are subject to excessive strain, they can develop tiny tears and areas of inflammation. The body reacts by storing calcium in those places, in an attempt to stabilise the injury. Over time, this can lead to a bone-like heel spur. It is usually only a few millimetres long. Given that heel spurs are the result of an inflammation of the plantar fascia, this condition is also known as plantar fasciitis.
They most frequently affect people between the ages of 40 and 60. Excessive strain on the heel, a malposition of the foot, playing sport without warming up beforehand and excessive body weight can all promote the development of a heel spur.
The main symptoms include stabbing heel pain triggered when a load is placed on the heel (e.g. when standing or walking). It is also common to experience pain in the morning after getting out of bed. In its early stages, the pain normally disappears after the pressure being exerted on the heel stops. In its advanced stages, the pain may last for longer or even occur when the foot is being rested.
During a heel spur examination, the area where the tendons connect to the heel will be tested for sensitivity to pressure, because this sensitivity indicates plantar fasciitis. A heel spur diagnosis is confirmed using x-ray imaging.
Heel spurs can usually be treated without surgery. It is important to rest the affected heel. In acute cases, the inflammation can be treated using local anti-inflammatory injections and pain killers are used to relieve the pain. Special shoe insoles can reduce the pressure on the heel and prevent the heel spur from coming into direct contact with the ground. The calcium deposits can be broken down using high-frequency shockwave therapy (sound waves).