The average American takes more than 5,000 steps every single day. Over the course of our lifetimes, these small steps add up to tens of thousands of miles, and this mileage can wear on our feet, resulting in various injuries and chronic conditions. For approximately 10 percent of people, these wear-and-tear foot injuries will eventually include heel bone spurs. Heel bone spurs are small, bony protrusions that can severely limit mobility and make even walking around the home a burdensome and painful chore. Fortunately, many patients suffering from foot pain related to bone spurs can experience symptom relief with nonsurgical options. In this post, we will answer many of the most frequently asked questions pertaining to bone spurs. So what are bone spurs, and what are your bone spur treatment options? Let’s take a look...
Before we touch on heel spur treatment, let’s first discuss what causes these painful spurs in the first place. Heel spurs are basically just excess calcium deposits that collect on the bottom of the calcaneus, also known colloquially as the heel bone, over a long period of time. The formation of these bony growths may be related to other conditions or lifestyle factors. For example, improperly fitting or poorly padded shoes may lead to the development of heel spurs. Overweight individuals have an increased risk of developing heel bone spurs, as do individuals with arthritis and certain gait abnormalities, such as overpronation (also known as flat feet). Strain on the bones and connective tissues of the foot from exercises such as running and jogging may also contribute to the growth of heel bone spurs.
Regardless of the underlying cause, there are many common heel spur symptoms. Many individuals will experience more pronounced heel spur pain early in the morning or after extended rest. For some, heel spur pain may manifest as a sharp pain along the bottom of the foot. Heel spur pain may also be mild and exist as a dull ache throughout the day, especially during and after rigorous activities. Other foot bone spur symptoms include inflammation and tenderness along the bottom of the foot, known as plantar fasciitis. With larger bone spurs, there may even be a visible protrusion where the spur has formed. A physical examination and other diagnostic imaging may also be utilized to properly diagnose the underlying cause of a patient’s mild or severe heel pain. It’s important to note, however, that not all heel spurs will result in discomfort or pain. In fact, only about 5 percent of individuals with heel bone spurs will experience foot pain, according to the American Academy of Orthopedic Surgeons.
Once the condition has been properly diagnosed, your healthcare provider will recommend appropriate heel bone spur treatment. Fortunately, many patients are able to achieve adequate relief from bone spur pain with nonsurgical heel spur treatment. In fact, “more than 90 percent of patients with plantar fasciitis will improve within 10 months of starting simple treatment methods,” according to the American Academy of Orthopedic Surgeons. In many cases, this treatment may include lifestyle adjustments. For patients who are overweight, losing excess pounds may help reduce the stress on the affected foot and heel during weight-being activities. For athletes suffering from bone spur pain, it may be necessary to reduce the intensity and frequency of activities known to cause symptom flare-ups. For those with milder heel spur symptoms, it may be possible to perform adequate heel spur treatment at home, with a regimen of rest, ice, compression, and elevation. (To learn more about the RICE method, feel free to read our recent blog post on effective ice and heat therapy.) Additionally, nonsteroidal anti-inflammatory medication (NSAIDs) can be taken to assist with general pain and swelling following rigorous activities and during symptom flare-ups. Because some bone spur pain symptoms are associated with tight muscles and connective tissues in the foot and lower leg, other heel spur treatment at home may take the form of a daily stretching regimen.
A basic calf stretch can be achieved by simply placing the balls of your feet along the edge of a step while facing upstairs, and then slowly and safely lowering your heels. Seated stretches may also be achieved using assistive bands to pull the tops of the feet toward the body. A healthcare provider may recommend more targeted exercises designed to stretch the plantar fascia, and these are often most effective when performed early in the day prior to rigorous activity. Night splints may also be used to keep the ligaments of the foot, namely the plantar fascia, relaxed during the night. Properly fitting shoes, heel pads to cushion the bottom of the foot, and inserts to minimize gait abnormalities (such as high arches or overpronation) may be beneficial. These assistive devices and inserts may help reduce strain along the plantar fascia.
Depending on the severity of the condition, a provider may recommend a complete physical therapy regimen, involving both stretches and other heel spur exercises to reduce pain and discomfort. In these cases, a therapist will tailor a physical therapy regimen to the individual patient. Once the patient feels comfortable, these exercises for plantar fasciitis and heel spur pain may be performed independently at home. Cortisone heel spur injections may also help reduce pain and swelling. However, it’s important to note that these shots will only offer temporary heel spur pain relief, and patients will need to return for cortisone heel spur injections throughout the year for long-lasting results.
If the previous nonsurgical treatment options have failed to relieve a person’s heel spur pain, surgery may be necessary. Once your specific condition has been diagnosed, your provider will discuss your specific heel spur surgery options. Heel spurs may develop alongside other conditions, namely plantar fasciitis, and this will affect treatment options. Plantar fasciitis is an inflammation of the plantar fascia ligament that runs along the bottom of the foot, which can lead to the development of bone growths along the heel. The pain associated with this type of heel spur is often specifically associated with the inflamed ligament itself. If this is the case, your doctor may recommend a procedure known as plantar fascia release. During a plantar fascia release surgery, the surgeon will remove a portion of the ligament to reduce inflammation and pain. This procedure may be performed as an endoscopic or open procedure. The endoscopic procedure will involve smaller incisions and shorter recovery times than the open procedure. Your doctor will recommend one of these procedures based on your specific condition. In some cases, it may be necessary to remove the heel spur as well, although heel spur removal surgery is less common than the previously mentioned strategies. Generally, your provider will only recommend heel bone spur removal after the previous heel spur treatment options have failed to offer symptom relief. During heel spur removal surgery, the surgeon will remove the calcium deposit along the heel. This procedure may also be either open or endoscopic, and like plantar fascia release, this will vary on a case-by-case basis.
Following heel spur surgery, individuals should anticipate wearing a bandage over the incision for up to two weeks. Crutches are often used to assist with weight-bearing activities during the heel spur surgery recovery process. Over-the-counter pain medications can help with mild pain and discomfort. The RICE method should be used to help minimize pain and swelling immediately after surgery. Bandages and wraps may be used to achieve compression. Keeping the surgically treated foot elevated (ideally above the heart) will also minimize swelling. While most patients should expect a heel spur surgery recovery time of a few weeks, it may take up to three months for some patients to make a full recovery following heel bone spur surgery.
Today, effective bone spur treatment is enabling millions of individuals to live an active, pain-free lifestyle for decades to come. At Sports Medicine Oregon, we can provide the latest conservative care treatments at our state-of-the-art facility, with services ranging from outpatient physical therapy and the latest regenerative injections to minimally invasive surgery. If you or a loved one are dealing with bone spur pain and discomfort, our experienced medical team will tailor a specific treatment strategy based on your specific injury or condition, to help you live the active, pain-free lifestyle of your dreams. Please consult with our providers to see which treatment would work best for your foot issues.
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