When people come into our office complaining about heel pain, they often ask about heel spurs. These hard, bony deposits are a frequent side effect of chronic plantar fasciitis, which is the most common cause of heel pain in American adults. Although not always painful on their own, they can cause discomfort depending on their size and location.
A heel spur is a deposit of calcium that builds up on the underside of the heel bone, toward the front. This process occurs gradually, usually over the course of several months.
Spurs typically form in response to chronic, untreated plantar fasciitis, or other chronic soft tissue injuries and stress near the heel bone. For a variety of reasons—shoes, abnormal foot structure, overuse, etc.—the fibrous plantar fascia tissue may stretch and tear, pulling away from the heel. At the same time, the membrane covering the heel bone may also tear. This creates the opportunity for calcium to deposit on the heel bone, gradually forming a spike-like bony enlargement that may reach a half and inch long or more.
Not necessarily, or even usually. Most of the time a heel spur will not cause any discomfort on its own. A heel spur, of course, may be present in someone with heel pain, but usually the soft tissue injury is the real source of the discomfort. Once the soft tissue injury, usually plantar fasciitis, heals, the spur itself will not cause any more trouble. In fact, quite frequently people don’t discover they even have a heel spur in the first place until they need an X-ray for an unrelated reason!
However, in a minority of cases—maybe 1 in 20—the spur continues to cause pain even after everything else has healed. This could be due to the spur pressing uncomfortably against more sensitive tissues, particularly when bearing weight. As with any other foot or ankle concern, if heel spurs are causing pain, they should be treated by a professional.
If you have a heel spur in addition to a painful soft tissue injury like plantar fasciitis, treatment will follow the normal course for the primary condition. In about 90 percent of cases or more, this resolves the problem within several weeks to several months, using only conservative therapies like rest, ice, stretching, and/or orthotics.
Heel spurs do not usually need to be removed surgically, particularly if they are not causing any pain. However, for those that do, we may perform a procedure to either release the plantar fascia and/or excise the spur itself. The post-surgery prognosis is usually quite good, although potential complications such as nerve pain, scarring, or infection are always possible. You’ll need to carefully follow your surgeon’s instructions for post-operative care to give yourself the best odds of a speedy and full recovery.
You do not have to live with the discomfort of heel pain. The doctors at Dallas Podiatry Works: Dr. Joel W. Brook, David R. Northcutt, Dr. Irene Arroyo, and Dr. John M. Baca, can obtain proper diagnosis and offer treatment that will eliminate your pain. Contact us in Dallas, TX at (972) 566-7474 or in Plano, TX at (972) 943-3323 for an appointment today.