Bone spurs are the result of the body laying down extra bony tissue on the edges of bones. In most cases these spurs are formed at the periphery of joints. Bone spurs can form on the calcaneus bone, which is the rear bone of the foot, leading to a painful condition known as heel spurs.
Symptoms
The main symptom of heel spurs is severe heel pain. The pain most often occurs when the patient attempts to put weight on the heel--this can be debilitating. The pain caused by heel spurs is a result of the body's inflammatory response to the spur. Pain from heel spurs is usually worse when a patient begins walking after a period of rest; continued walking will relieve the pain as the nerves and blood vessels adjust to the motion.
Causes
Heel spurs are the result of stress being placed on the heel joint. This is often caused by repeated stretching of the connective tissue that runs under the foot, also known as the plantar fascia. This stretching causes the fascia to pull away from the bones in the feet, leading to the body laying down extra bone material on the soft tissue. Most heel spurs occur in people over the age of 40. Osteoarthritis and rheumatoid arthritis can also contribute to heel spur formation.
Complications
Because heel spurs are less supported than the surrounding normal bone, they are prone to breaking off, according to the Mayo Clinic. This can cause them to form "loose bodies," which can float around in the joint or become caught in the lining. Loose bodies can migrate between the bones in the heel and cause the joint to lock up suddenly, obstructing movement within the joint.
Diagnosis
An older patient with heel pain who gets better with activity may be suspected of having a heel spur. In these cases the patient will be given a full physical exam. In some cases the physician will be able to manually feel the bony formation on the back of the foot. If the spur is small, however, or in a difficult-to-palpate location, further testing may be needed. Heel spurs can also be seen on an X-ray, as well as on MRIs and CT scans.
Treatment
Many patients experience pain relief by elevating their affected ankle and applying heat. Footwear can be modified to avoid irritation, either through the use of orthotic supports or by adding extra padding to the back of the patient's shoes. Diathermy is a technique that uses electrical currents to relax the muscles and nerves. Ultrasonic devices can be used to stimulate blood circulation. In the event that none of these treatments work, surgery can be performed to remove the spur.
