Home / Treatment / Causes and symptoms of heel spurs how to treat?

Causes and symptoms of heel spurs how to treat?

Heel spurs – what is it?

A heel spur is a growth of the calcaneus in the area of the hill with the plantar side or in the zone of attachment of the Achilles tendon. The expansion has the form of a spike or wedge. Also called heel spur plantar fasciitis.

The disease is widespread, its share in the total mass of pathologies of the musculoskeletal system is 10%. Spurs are most often diagnosed in women reach 40 years, although it is possible aseptic inflammation of the heel fascia in any age, any person in the presence of predisposing factors.

The content of the article:


Causes of heel spurs

Causes of heel spurs lies in the impact on the heel the fascia a variety of factors, primarily high loads. Fascia is of great importance in the formation and maintenance of the foot arch during walking it accounts for the entire weight of the person. Throughout her life, she is subjected to different loads in my old heel spur is formed by every fourth person.

The reasons for the formation of heel spurs is considered to be:

  • Foot injuries, heel injuries: fractures, bruises, sprains, etc.
  • Disease, accompanied by circulatory disorders, disruptions of metabolic processes.

  • Overweight, diabetes.

  • Excessive physical stress during doing sports. Professional athletes often suffer from heel spur since strenuous exercises contribute to the sprain, also increases the risk of injury. Athletic training cause the formation of spurs in a young age.
  • Regular wearing of high heel shoes. Negatively on the state of the fascia is reflected by the wearing of uncomfortable shoes, lack the cushioning of insoles in it, thin and hard sole.

  • The longitudinal flat feet. A heel spur is formed by 90% of people with this pathology. This is because the load distribution on the foot is uneven, the tendons suffer from excess tension, increasing the likelihood of injury.

  • Diseases of joints and spine. Such pathologies include: gout, arthritis, osteoarthritis. The increased symptoms observed in acute bursitis, periostitis.

  • Connective tissue disease can cause the development of heel spurs is such pathologies as: ankylosing spondylitis, rheumatoid arthritis.

  • Thinning of the fat cushion in the heel area because of age-related changes in the body.

  • Gout. (see also: causes, symptoms and treatment of gout on the legs)


The symptoms of heel spurs

The symptoms of heel spur can not remain unnoticed by man, as always accompanied by severe pain.

The clinical picture of the disease as follows:

  • First there is pain while walking or when making any other movement (running, jumping). The disease progresses the pain increases, causing the amount of suffering in the slightest reliance on the heel. Patients compare the pain with a heel nail. The character of the pain burning, sharp. The size of the lump the pain is not affected, although triggered by pressure from the enlarged bone tissue on the heel. So, patients with a small flat spurs may suffer from severe pain, and people with large growths experience only minor discomfort. Pain intensity depends mainly on the location of the spurs. The closer it is to the nerve endings, the more pain.
  • Sharp pain occurs after a night of rest. When a person begins to move, she had somewhat subsided, but the evening is growing again. Such cyclicity is caused by the fact that during sleep microreserve fascia fused with the shortening. Sick for a long time he lay, and the angle of inclination of the foot relative to the leg was not straight. When a person awakens, again raises micrometry, hence the sharp pain. As the fascia is stretched, and pain fewblunted, but the evening is intensified by stress and the formation of new microscopic gaps.
  • As soon as scar tissue formed around the heel spur begin to accumulate calcium, the human condition worsens. Pain that occurs during rest indicate that the calcification process has provoked the growth of osteophytes.
  • Patient's changing gait. This is due to the natural human desire to relieve the sore spot, namely the heel. A long shift of center of gravity from the heel to the front parts of the foot will lead to the fact that we have a transverse flat feet. It is especially difficult to move people if they have heel spurs are formed on two legs. These patients are often unable to do without everyday, so begin to use a cane or crutches.
  • Pain is able to become sustainable and disrupt the quality of life, making it for a long time unable to work.
  • The appearance of pathological changes in the heel area is not observed. Sometimes you can find mild swelling of the metatarsal area and its amosulalol.

Diagnosis of heel spurs

Diagnosis of heel spur is usually not difficult. The doctor is able to put a preliminary diagnosis based on the patient's complaints of pain in heel upon awakening, after prolonged walking or running. During the exam, the doctor will press on the base of the heel, and also laterally. These manipulations will trigger the appearance of pain in a patient with a spur. Specialist also evaluates limitations in mobility of the foot, if any.

To ensure that you have a formed heel spur patient sent to x-ray examination. It allows you to estimate the size of the education and the exact place of its location. Sometimes you may accidentally detecting the growth of bone when a patient is undergoing tests with a different objective. Thus any discomfort spur its owner does not deliver, and he does not even know of her presence.

In the picture you will see the spike localized on the surface of the calcaneal tuber. Spike bent in the direction of the fingers. In the early stages of the disease rounded education, but even in this case, it may cause discomfort. The spike can reach a length up to 12 mmshaping themselves in the form of a bird beak.

Sometimes doctors send the patient to the x-ray of the foot, but also on MRI,which allows you to assess the condition of soft tissues surrounding the spur. Ultrasound is very rarely used, as it is in this respect less informative. Ultrasound of the foot is recommended to pass to control of the treatment, as ultrasound examination should be performed more often than MRI and x-rays.


Different than heel spur from the spikes (Sipil)?

Don't confuse heel spurs and spikes (or tipici) on his feet. A heel spur is a bone formed on the heel bone under the soft tissues.

Chipita is a type of warts, which is localized on the soles or palms. Chipita caused by infection with human specific strain of human papillomavirus. She is perfectly visible to the naked eye and looks like a small nipple or nodule on the skin. The danger of sepici is that she can eventually transform into cancer.

The differences between spur and sepici obvious. They have different etiology and clinical course, so to compare the two diseases is incorrect.

Read more: causes and symptoms of sepic

How to treat heel spurs on the heel?

About how to treat heel spurs on the heel will detail specialist, who will specify a diagnosis on the survey results.

Methods with proven efficacy is considered to be:

  • Reducing the physical load on the foot, but parallel to the physical therapy must be completed with the subsequent taping.
  • Application of special orthoses or braces.
  • The wearing of insoles with arch supports.
  • The use of shock wave therapy.
  • Laser therapy.
  • Local injection with glucocorticoids.
  • Immobilization of the limb.
  • Surgery.
  • Ultrasonic treatment.
  • Radiotherapy.
  • Cryosurgery.

Unloading of the affected limb and the elimination of excessive pressure on the heel must precede any therapeutic activity.

Therefore, patients are given the following recommendations:

  • Compliance with bed rest;
  • Reduction of time walking and standing;
  • The use of orthoses in the night time;
  • The use of orthopedic insoles during walking;
  • The use of specialized appliances (crutches, canes,sticks).

Conservative therapy includes application of external medicines. These can be drugs from the group of NSAIDs, among which ointments: Diclofenac, Voltaren, Ibuprofen, Ketorol, Phenylbutazone, Piroxicam (in the form of gel), of indometacin ointment. The ointment is used up to 4 times a day for 2 weeks.

With the aim of pain relief, improvement of metabolic processes, reduce inflammation may be recommended such as: Dimexidum gel, Medical bile, the outer patches are plant-based.

Medicinal blockade is carried out in the case when conservative therapy does not give the desired effect. Drugs are injected into and allow you to not only eliminate pain, but also reduce inflammation. The procedure is carried out only by an experienced orthopedist, as important is the selection of the dose and depth of injection. Complications that threaten incorrectly held medicinal blockade is osteoporosis, necrosis, inflammation of tendons, etc. To eliminate the pain performing novocaine blockade is not more than 2 times a day and only during exacerbation of the disease. To relieve pain and inflammation, and resorption of calcification used corticosteroids Diprospan, Flosteron, Kenalog. Patients should not enter more than 1-3 injections.

Effective in combination with other methods of physiotherapy treatment techniques, such as medicated bath (paraffin, mineral, radon, mud), massage, electro - and phonophoresis, magnetotherapy.

Complex physical therapy is chosen individually in each case, however, after any exercise specialists recommend to carry out taping. Taping is an imposition on the foot band-aid or athletic tape on a particular technique. Options overlay, there are several, but they all have the goal of fixing the plantar fascia in a lengthened state.

A comprehensive treatment of the spurs may include the use of night orthoses. This is a special device for fixing the foot at a right angle. In the end, the night's not gonna happen the fusion fascia with shortening. This method allows you to avoid the morning pain, or significantly reduce them.

If conservative methods do not help to get rid of the problem, it is necessary to resort to surgical treatment. In the course of operations in the area spur the incision is performed, the build-up is removed and sewn with a fabric.

Modern surgical method of getting rid of the heel spur is an endoscopic dissection of the fascia. The procedure is performed using endoscopic equipment, due to which the incision will be small – no more than 5 mm each. In one incision, introduce the endoscope and another surgical instrument. The doctordissecting the fascia of the sole, removing the voltage, then remove the spur itself. In addition, the possible removal of heel spur under the control of the x-ray apparatus. It should be noted that surgical intervention doctors used very rarely.

Shock wave therapy

Shock wave therapy for the treatment of heel spurs is recognized as a highly effective method for coping with the problem. For this procedure, use special equipment that exudes the shock of the sound wave. They influence the affected zone, reducing the sensitivity of pain receptors.

In addition, thanks to shock wave therapy are able to loosen the calcification, reduces water retention, to accelerate metabolism. This method greatly accelerates the recovery of the patient. Duration of one session does not exceed 30 minutes. Between each procedure should take 3 to 20 days. One course recommended from 5 to 7 treatments.

Advantages of shock wave therapy for heel spur treatment:

  • Side effects procedure prevents;
  • Therapy is highly effective;
  • There is an opportunity to avoid surgery;
  • No pain;
  • The gradual disintegration of the calcification;
  • The possibility of outpatient treatment;
  • Short duration of the procedure in time.

Disadvantages of shock wave treatments in the treatment of the spur are only a few contraindications. So, the session is not for people under 18 years of age, during pregnancy, hypotension, thrombophlebitis of veins of the lower extremities, an exacerbation of any infectious diseases.

The effectiveness of treatment for heel spurs with the help of this method reaches 90%. Shock wave therapy can act as an independent method of treatment of the disease. However, if desired, it can be combined with conservative therapy and other physical treatments.

Read more: Shock wave therapy heel spurs

Laser from heel spurs

Laser treatment is used in the absence of an effect of ongoing conservative therapy. Due to laser beam able to reduce swelling, inflammation and pain, faster recovery of damaged tissue. However, to remove the bone growth with the use of laser will fail.

Treatment rates, for the first year, appoint not more than 10 procedures. Theiryou must perform daily. After 2 weeks, repeat the course.

The benefits of heel spur treatment by laser:

  • If the patient takes drugs, their therapeutic effect will be enhanced;
  • No side effects;
  • The healing process will be accelerated;
  • The effect persists for a long time;
  • The probability of allergic reactions is absent;
  • The procedure does not require hospitalization of the patient.

Disadvantages of heel spur treatment by laser:

  • To get rid of the bony growth will fail;
  • The presence of contraindications (tumors, diabetes, cardiac and pulmonary insufficiency, thyrotoxicosis).

Ultrasound in the treatment of heel spurs

Ultrasound treatment involves the exposure of the calcaneal spur with the help of ultrasonic waves that emanate from a special device. This therapy allows you to relieve swelling and inflammation, and break up the salt deposits.

The session is not continuous in time and does not take more than an hour. The course should take 5 to 7 treatments, the interval between them should be at least a week.

The benefits of heel spur treatment with ultrasound:

  • No pain;
  • The possibility of getting rid of bone growth;
  • The short duration of the procedure;
  • No need for hospitalization.

Disadvantages of heel spur treatment with ultrasound:

  • The high price of the procedure, due to the need to acquire specialized equipment;
  • Contraindications: heart failure, hypotension, period of carrying a child, thrombophlebitis of veins of the lower extremities, disorders of the nervous system.

X-ray heel spur

Radiotherapy of calcaneal spurs is carried out by exposure to the problem area using x-rays. Spur has such a location that the therapy can be carried out without harm to the entire body.

Radiotherapy is appointed in that case when other methods are ineffective. Doctor with x-ray apparatus directs an x-ray beam on the heel, to the place where there is bone overgrowth. In the resultthe nerve endings are blocked, so the person will no longer experience pain. The duration of treatment averages 10 minutes. The full course consists of 10 sessions.

The benefits of radiotherapy in the treatment of heel spurs:

  • Painless procedure;
  • The brevity of the session.
  • For getting rid of the pain enough 1.
  • Anti-inflammatory and analgesic effect prolonged in time;
  • The treatment is conducted in the condition of the dispensary;
  • The effect is purposefully only on the affected area.

Disadvantages of radiotherapy in the treatment of heel spurs:

  • Potential risk to the health of a patient due to exposure to ionizing radiation;
  • Security method is not scientifically proven, long-term observations in patients who have received such therapy was not carried out;
  • The presence of contraindications, including: pregnancy, patient age older than 40 years, the exhaustion, all diseases in the stage of decompensation, blood diseases, radiation sickness.

Read more: advantages and disadvantages of x-ray heel spur

Cryosurgery

Cryotherapy is a modern technique for the treatment of superficial formations, so for the treatment of heel spurs this method is not suitable. However, it can be successfully used to eliminate spikes on the heel. As a result, the patient will have no scars, the procedure itself is quick, the risk of recurrence of the disease decreases.

In conclusion we can add that the development of the disease can be prevented, if to get rid of flatfoot, from disease of the spine. Shoes that a man wears should be comfortable and orthopedic well-matched. If you experience symptoms should immediately seek the advice of a specialist.