A heel spur is a bony deposit, generally formed on the bottom surface of the heel. A a heel spur is often the result of too much strain placed on the plantar fascia, the connective tissue that runs from the base of the toes to the heel. A heel spur forms in an attempt to strengthen the area of abnormal strain and injury. Heel spurs can exist without causing pain.
Anti-inflammatory Measures
Heel spurs often form when the plantar fascia begins to tear away from the heel bone due to excessive strain. The inflammation that occurs results in pain, especially first thing in the morning. To control inflammation, the patient should modify activity to eliminate sources of excessive strain, such as running and jumping. The patient should ice the foot three times a day, for 20 minutes, in an ice and water bath, to control pain and inflammation. A physician may recommend the use of anti-inflammatory medications on a short-term basis and a trial of wearing a foot splint or boot. Occasionally, if conservative measures prove ineffective, the physician may inject the area with cortisone.
Physical Therapy
The patient must address the cause of the heel spur--plantar fasciitis--or any improvement in symptoms will prove to be only temporary. Physical therapists will focus on increasing the flexibility of the lower leg, with a stretching program that the patient will do at home several times per day. The physical therapist will also evaluate the alignment and mechanics of the foot and attempt to correct abnormalities with shoe inserts and taping. Exercises to strengthen the muscles of the legs and feet may also improve the patient's foot mechanics and decrease strain placed on the heel.
Surgery
According to the American Academy of Orthopaedic Surgeons, most heel pain will eventually resolve with conservative measures, and surgery is rarely necessary. In certain instances, when conservative measures have failed to provide relief and sufficient time has passed, a surgeon will perform a plantar fasciotomy and spur excision. A fasciotomy involves releasing the fascia from the heel itself. According to American Family Physician, the overall success rate of this surgery in 70 to 90 percent; potential complications include flat foot, decreased sensation in the foot and rupture of the plantar fascia.
