Diagnosing Posterior Calcaneal Spur

Posterior Calcaneal Spur

Overview

A heel spur is an overgrowth of bone that resembles a hook on the bottom of the foot. It is a reaction to stress placed on the thick connective tissue on the bottom of the foot (plantar fascia) that helps maintain the arches of the foot. Over-stress can stem from improper support of the feet. A heel spur is often accompanied by a bursitis that is a major contributor to pain.

Causes

Fctors that increase the risk of developing heel spurs include a high body mass index (BMI), regular vigorous activity, and intensive training routines or sports. Factors such as these are believed to increase the incidence of repetitive stress injuries that are associated with the formation of heel spurs. When a heel spur forms, extremely sharp pain along with the feeling that a part of the heel is trying to burst through the skin usually occurs. If left untreated, an individual may eventually begin to struggle to perform simple activities such as walking.

Heel Spur

Symptoms

Most bone spurs cause no signs or symptoms. You might not realize you have bone spurs until an X-ray for another condition reveals the growths. In some cases, though, bone spurs can cause pain and loss of motion in your joints.

Diagnosis

A heel spur is often seen on X-ray as a bony protrusion, which can vary in size. However, because a Heel Spur only indicates increased load on the plantar fascia, and not pain, an ultra sound may be required to assess other actual cause of the heel pain such and may include checking to see if the plantar fascia is inflamed or degenerated.

Non Surgical Treatment

Treatments for bone spurs and plantar fasciitis include Stretching the calf muscles several times daily is critical in providing tension relief for the plantar fascia. Some physicians may recommend using a step to stretch, while others may encourage yoga or pushing against a wall to stretch. Icing after activity. A frozen tennis ball can provide specific relief. Rolling the tennis ball under the arch of the foot after exercise can lessen pain in the area. Taping is also recommended at times. Several manufacturers of sports tape have plantar fascia specific lines. Orthotics are a good idea for those on their feet during the day. Orthotics can provide cushioning and relief. Cortisone shots in the fascia can provide temporary anti-inflammatory relief. Losing weight is perhaps the most effective method of improving heel and foot pain. Those who are overweight are far more likely to report these syndromes.

Surgical Treatment

Surgery involves releasing a part of the plantar fascia from its insertion in the heel bone, as well as removing the spur. Many times during the procedure, pinched nerves (neuromas), adding to the pain, are found and removed. Often, an inflamed sac of fluid call an accessory or adventitious bursa is found under the heel spur, and it is removed as well. Postoperative recovery is usually a slipper cast and minimal weight bearing for a period of 3-4 weeks. On some occasions, a removable short-leg walking boot is used or a below knee cast applied.

Prevention

Walk around before you buy shoes. Before you purchase your shoes, do the following. Re-lace the shoes if you’re trying on athletic shoes. Start at the farthest eyelets and apply even pressure to the laces as you come closer to the tongue of the shoe. Make sure that you can wiggle your toes freely inside of the shoe. Also, make sure that you have at enough space between your tallest toe and the end of the shoe. You should have room equal to about the width of your thumb in the tip of your shoe. Walk around to make sure that the shoe has a firm grip on your heel without sliding up and down. Walk or run a few steps to make sure your shoes are comfortable. Shoes that fit properly require no break-in period.

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