Although people walk and stand on their feet every day, few give any thought to how much work feet do and the stress they endure. To put this into perspective, a person living an average lifespan will walk approximately 24,855 miles, which is the equivalency to walking around the equator five times! With this information, it becomes much easier to understand the tremendous demand placed on feet and why different types of foot problems associated with overuse and stress develop.
Of course, time spent on the feet is not all on flat surfaces but varied terrain to include stairs, incline walkways, hills, and so on. Additionally, the degree of stress and pressure placed on the feet would depend on a person’s physical weight, type of shoes worn, speed of walking or running, amount of time, and again, surface. Taking feet for granted is easy to do until a problem arises such as a bone spur in the heel. Although there are other foot conditions more serious, the presence of a bone spur is painful.
What is a Heel Bone Spur?
Although a bone spur in the heel is relatively common, some people experience only slight discomfort while other people become debilitated. To understand a bone spur, as well as the way it develops, a person would need some insight into the foot’s anatomy. For starters, the word used to describe the bottom of the foot is Plantar, which is comprised of nerves, bones, and connective tissue called fascia. Any time the Plantar becomes inflamed, a condition known as “Plantar fasciitis” exists.
Due to inflammation but also tension that developed in the Plantar fascia portion of the heel, a calcium deposit forms, which is the bone spur in the heel. This bone hook typically forms on the calcaneus or heel bone and of people diagnosed with Plantar fasciitis, approximately 70% also have a bone spur in the heel. While medical experts agree a direct correlation between Plantar fasciitis and a bone spur in the heel exists, the exact relationship remains somewhat of a mystery.
Development of Bone Spurs
When looking at the connective tissue on the bottom of the foot or the Plantar fascia, it is quite thick and dense with ligaments. This tissue goes from the calcaneus, which is the heel bone, up to the ball of the foot, helping to maintain the arch. Along with this function, the Plantar fascia is a primary weight transmitter needed for walking or running. For this reason, when someone is on the feet for long periods or the feet are overworked as in sports, this connective tissue is stressed.
At the point when the Plantar fascia becomes inflamed and begins to degenerate, intensity of pain increases. Typically, pain, stiffness, and swelling are more prominent first thing in the morning due to the tissue being taut. However, once out of bed and walking around, the Plantar fascia begins to loosen up, which in turn allows swelling and pain to decrease. Regarding a bone spur in the heel, often individuals with Plantar fasciitis or those who have had problems with the Plantar fascia for long periods are at greatest risk.
If a bone spur in the heel were suspected, an x-ray would be taken by the doctor. Seeing a hook of bone sticking out from the Plantar at the point where the Plantar fascia and heel bone attach, the doctor would know a bone spur in the heel were in fact the problem. A misconception is that the bone spur is the cause of pain but in reality, pain comes from inflammation and irritation of the Planter fascia. This is why an x-ray is needed to make a diagnosis since about 50% of people with a bone spur related to Plantar fasciitis have no pain.
Getting Proper Treatment
Currently, there is no known cure for Plantar fasciitis or the bone spur in the heel but there are viable treatments that would provide a significant improvement. With these two issues being related, it is convenient that the treatment for both is the same. Therefore, if someone had Plantar fasciitis but no bone spur or had the inflammation of the connective tissue along with a bone spur in the heel, the following treatment options would be beneficial.
o Rest – While this would be difficult, especially for people on the go, it would be essential for the foot to have rest. Even two to three days of not participating in physical activities or standing for long periods would help. During this time, swelling of the tissue would reside along with pain.
o Ice – Using ice packs is another excellent treatment option for a bone in the heel, as well as Plantar fasciitis
o Stretching Exercises – A number of stretching exercises would loosen the Plantar fascia up, thereby relieving pain. These exercises should be done first thing in the morning since this time of day is worse.
o Anti-Inflammatories – A doctor might also want to prescribe some type of anti-inflammatory medication to bring any swelling down. For milder cases, an over-the-counter product would suffice.
o Shoe Modification – The goal in this case would be to use shoe inserts as a means of lifting and providing better support to the foot’s arch. In most cases, shoe inserts are so beneficial for both Plantar fasciitis and a bone spur in the heel that a person could go through a normal day without being in agony.
o Splints – The last treatment a person could consider is with splints that would be worn during the night to stretch the heel so the connective tissue or Plantar fascia does not tighten.
Advanced Treatment Options
Sometimes, a person could try all of the above-mentioned treatments without getting adequate relief. In a case such as this, a doctor may want to administer a cortisone injection. With this, cortisone would be delivered directly into the Plantar fascia, which would have a direct effect on the inflammation. One important note is that any injection of cortisone in the heel of the foot should be given by a doctor with expertise in this area in that given incorrectly could create additional problems.
In cases where a bone spur in the heel has grown large or hooked in such a way that it is doing additional damage, surgery to remove the piece of bone may be required. Surgery such as this would be performed on an outpatient basis with healing time of a few weeks. While not yet being offered, an innovative treatment known as Extracorporeal Shock Wave Therapy is being researched and tested. With this, micro-trauma of the tissue surrounding the bone spur in the heel would be induced with energy pulses.
Regardless of the treatment option suggested by the doctor, eliminating all inflammation and pain takes time. Typically, a person would need to use one or more treatments for a period of three to four months to see the desired results but in more severe cases, it could take a full year for all inflammation and pain associated with Plantar fasciitis and a bone spur in the heel to subside.
For more information on Heel Spurs, view:
- Understanding the Cause of Heel Pain
- Causes and Prevention Methods of Heel Spur
- An Overview of Heel Spur Symptoms
- What is Plantar Fasciitis?