Dallas Heel Spur Treatment

Heel spurs are calcium deposits that settle on the heel bone over a lengthy period of time. Pre-existing conditions, as well as activity levels and lifestyle decisions contribute to the formation of heel bone spurs. If you wear poorly-fitting shoes, or shoes without sufficient padding, you may experience heel spur formation. 

Additionally, individuals who are overweight, have arthritis, or who have abnormal strides are at higher risk for heel bone spur formation. One example of an abnormal stride is overpronation, which involves the ankle rolling inward and downward during each step. This is seen more often in individuals with flat feet. Strain on the feet from these conditions, as well as running and jogging, contribute to the formation of heel spurs.

Heel spur calcium deposits form on the underside of the heel bone. They appear as bony protrusions, extending outward from the heel bone for up to half an inch. Many people associate heel bone spurs with plantar fasciitis, which is inflammation of the connective tissue that runs from the calcaneus bone (heel bone) to the ball of the foot.

Heel bone spurs are usually painless, with only about 5% of people with heel spurs experiencing any pain at all. While they are usually extremely mild, larger spurs cause great discomfort and pain for some individuals.

Symptoms of heel spurs include pain and inflammation, as well as visible projections where the actual spur is beneath the skin. Pain associated with this condition can be either chronic or intermittent, depending on the sources of the heel spur, as well as whether or not inflammation occurs at the site of the spur.

Chronic and intermittent pain result from damage to the tissue surrounding the heel spur, rather than the heel spur itself. This pain comes with inflammation at the site, and is more common during certain activities, such as jogging, running, or even walking.

Imagine that you have a small thumbtack or knife sticking into the bottom of your foot right after you get up in the morning. This is how many people describe their pain from heel spurs. This initially sharp morning heel pain dulls into more of an ache as the day progresses, but becomes sharp again after long periods of sitting or lying down.

Over the course of many months, calcium deposits can build up on the underside of your calcaneus (heel) bone. This is how the heel spur itself forms, but it is not the cause. Many times, individuals who experience heel spurs may have stretched or strained the ligaments or muscles of the bottom of their feet. In athletes or highly active people, this repeated damage to the underside of the foot causes heel spurs to form.

Certain risk factors exist that increase your likelihood of experiencing heel spurs. Below, we list some of the common risk factors associated with heel spur formation.

• Stride abnormalities, such as overpronation, which excessively stress the heel bone, as well as its surrounding nerves or ligaments
• Frequent jogging, running, or walking on hard surfaces
• Ill-fitting footwear, or footwear with poor arch support
• Obesity or excess weight
• Aging, which results in thinning of the pad of the foot, as well as a loss of flexibility of the ligaments
• Diabetes
• Excessive standing
• High arches or flat feet
• Excessive physical activity, either in short bursts, or long periods

During your examination, there are certain details that our experienced orthopedic professionals will look for. If you have tenderness on the bottom of your foot, a high arch, worsening pain from flexing the foot, or limited upward mobility of your ankle, these are likely indications of heel spurs. 

In order to confirm your diagnosis, we may order imaging tests such as X-rays to certify that your pain is coming from a heel spur and not a completely different problem. On rare occasions, we may also order an MRI or an ultrasound.

Treatments for heel spurs cover a variety of options, including at-home treatments and surgical options for more extreme cases. You might think that, as with many physical conditions, rest is the best form of at-home treatment for heel spurs. This is not always the case. Sometimes, heel pain is caused by issues with the Achilles tendon. In this case, you may need percutaneous Achilles tendon repair surgery.

After sleep or long periods of rest, the pain will likely worsen at first, and then decrease as you walk throughout the day. At SPORT, we recommend the following simple treatments:

• Simple stretches of the calf and heel
• Proper footwear with optimal padding and arch support
• Strapping or taping the stressed muscles and tendons of the bottom of the foot
• Visiting a top Dallas physical therapy clinic
• Insoles for shoes without proper padding or arch support
• Braces or orthotic devices (orthoses)

If excess weight is a cause of your heel spur, certain lifestyle modifications may be necessary. Losing excess weight helps to reduce the stress that is placed on the foot during activities that require standing, running, or jumping. Additionally, those who lead an active lifestyle should consider reducing the frequency of their physical activity until the heel spur problem dissolves. You can also take over-the-counter medications to reduce discomfort. 

Performing daily stretches is extremely beneficial for patients who experience heel spurs. Stretching the calves and the plantar fascia (arch of the bottom of the foot) is essential for flexibility of the foot’s ligaments and muscles. Perform your stretches early in the day before you start your normal activity. If your pain persists, we recommend setting up an appointment with one of our experienced physical therapists who will tailor a physical therapy regimen to fit your specific needs.

If none of these solutions resolve the problem, we will recommend corrective surgery.

While 90% of patients do not require surgery for heel spurs, these conservative treatments do not always work. If your condition does not improve after prolonged nonsurgical treatments, one of our experienced Dallas orthopedic surgeons will recommend surgery. We recommend one of two main surgical options for heel spurs.

1. Plantar fascia release: This process involves removal of a portion of the ligament. This will reduce pain and inflammation in the affected area. Our surgeons will either perform this procedure openly or endoscopically. Endoscopic procedures involve shorter recovery times and smaller incisions than open procedures.
2. Spur removal: We might also remove the heel spur itself, but this is less common than the above procedure. During this process, your surgeon will remove the heel spur either openly or endoscopically. Both of these procedures vary on a case-by-case basis, and our specialists have the knowledge to decide which process is best for you.

Generally, we recommend that you wear a bandage over the site of the incision for up to two weeks after your surgery. Crutches assist in keeping the weight off your foot during the recovery process. We also recommend taking over-the-counter pain medications to reduce pain and swelling. Keep your foot elevated while sitting or lying down.

Most of our patients recover over the course of a few weeks, but it can take as long as three months to achieve full recovery.