Heel Spurs Health Article

Allopathic treatment

Heel spurs and plantar fascitis (inflammation of the plantar fascia) are usually controlled with conservative treatment. Early intervention includes stretching the calf muscles while avoiding reinjury to the plantar fascia. Decreasing or changing activities, losing excess weight, and improving the fit of shoes are all important measures to decrease foot pain. Modification of footwear includes well-padded shoes with a raised heel and better arch support. Shoe inserts recommended by a healthcare professional are often very helpful when used with exercises to increase the strength of the foot muscles and arch. The inserts prevent excessive pronation and continued tearing of the plantar fascia.

To aid in the reduction of inflammation, applying ice for 10–15 minutes after activities and the use of anti-inflammatory medications, such as aspirin or ibuprofen, can be helpful. Corticosteroid injections may also be used to reduce pain and inflammation. Physical therapy can be beneficial with the use of heat modalities, such as ultrasound, that create a deep heat and reduce inflammation. If the pain caused by inflammation is constant, keeping the foot raised above the heart and/or compressed by wrapping with a bandage will help. Taping can help speed the healing process by protecting the fascia from reinjury, especially during stretching and walking.

In 2000, a number of U.S. podiatrists were experimenting with a new technology known as Extracorporeal Pressure Wave Treatment (EPWT). This technology is similar to lithotripsy, which uses sound waves to break up kidney stones. Cost of EPWT was roughly comparable to that of surgery. Initial reports from practitioners using the treatment were positive.

Heel surgery

When chronic heel pain fails to respond to conservative treatment, surgical treatment may be necessary. Heel surgery can provide pain relief and restore mobility. The type of procedure used is based on examination and usually consists of releasing the excessive tightness of the plantar fascia, called a plantar fascia release. The procedure may also include removal of heel spurs.

Expected results

Usually, heel spurs are curable with conservative treatment. If not, heel spurs are curable with surgery, although there is the possibility of them growing back. About 10% of those who continue to see a physician for plantar fascitis have it for more than a year. If there is limited success after approximately one year of conservative treatment, patients are often advised to have surgery.

Prevention

To prevent this condition, wearing properly fitted shoes with good arch support is very important. If a person is overweight, weight loss can help diminish stress on the feet and help prevent foot problems. For those who exercise frequently and intensely, proper stretching is always necessary, especially when there is an increase in activities or a change in running technique. It is not recommended to attempt to work through the pain, as this can change a mild case of heel spurs and plantar fascitis into a long-lasting and painful episode of the condition.

In 2002, researchers attempted to compare the effects of various running techniques on pronation and resulting injuries like stress fractures and heel spurs. They suggested that it is possible to teach runners to stride in such a way as to minimize impact forces. One way is to lower running speed. Another is to take longer rest periods following a run.

BOOKS

Perkins, Kenneth E. "Lower Extremity Orthotics in Geriatric Rehabilitation." In Geriatric Physical Therapy, edited by Andrew Guccione. St. Louis, MO.: Mosby Year Book Inc., 1993.

PERIODICALS

Feeny, Tracy. "If The Shoe Fits." Advance Magazine for Physical Therapists. (July 1997): 7.

Hreljac, Alan. "Technique Impacts Overuse Injuries in Runners—Research Suggests Impact Forces and Rate of Pronation Influence Risk of Injury." Biomechanics. (September 1, 2002): 51.

ORGANIZATIONS

American Orthopedic Foot and Ankle Society. 222 South Prospect, Park Ridge, IL 60068.

American Podiatry Medical Association. 9312 Old Georgetown Road, Bethesda, MD 20814.

OTHER

Roberts. Plantar Fascitis. http://www.heelspurs.com (1998).

David Helwig