The Diagnosis Of Inferior Calcaneal Spur

Heel Spur

Overview

The plantar fascia is connective tissue on the sole of your foot. When the arch of the foot is not properly supported, the plantar fascia can stretch and pull away from the heel area. When the plantar fascia pulls away from the heel, calcium deposits form in its absence. These calcium deposits are called heel spurs and can be very painful.

Causes

Everyone can be affected by heel spurs, however, certain groups of people have an increased risk. For example, Plantar Fasciitis is a common running injury. People who walk a lot are much more likely to have heel spurs or people who play golf or play tennis. Over-weight people are also more at risk for heel bone spurs as our feet are not designed to carry around extra weight. As a result the ligaments under the foot are placed under constant stress, which inevitably will lead to foot problems.

Inferior Calcaneal Spur

Symptoms

Symptoms of heel spur syndrome often include pain early in the morning or after rest, as you take the first few steps. It may also include severe pain after standing or walking long hours, especially on hard cement floors. Usually more pain exist while wearing a very flat soled shoe. A higher heel may actually relieve the pain as an arch is created. The pain is usually sharp, but can also be a dull ache. The pain may only be at the bottom of the heel, or may also travel along the arch of the foot.

Diagnosis

Diagnosis is made using a few different technologies. X-rays are often used first to ensure there is no fracture or tumor in the region. Then ultrasound is used to check the fascia itself to make sure there is no tear and check the level of scar tissue and damage. Neurosensory testing, a non-painful nerve test, can be used to make sure there is not a local nerve problem if the pain is thought to be nerve related. It is important to remember that one can have a very large heel spur and no plantar fasciitis issues or pain at all, or one can have a great deal of pain and virtually no spur at all.

Non Surgical Treatment

If pain and other symptoms of inflammation-redness, swelling, heat-persist, you should limit normal daily activities and contact a doctor of podiatric medicine. The podiatric physician will examine the area and may perform diagnostic X-rays to rule out problems of the bone. Early treatment might involve oral or injectable anti-inflammatory medication, exercise and shoe recommendations, taping or strapping, or use of shoe inserts or orthotic devices. Taping or strapping supports the foot, placing stressed muscles and tendons in a physiologically restful state. Physical therapy may be used in conjunction with such treatments. A functional orthotic device may be prescribed for correcting biomechanical imbalance, controlling excessive pronation, and supporting of the ligaments and tendons attaching to the heel bone. It will effectively treat the majority of heel and arch pain without the need for surgery. Only a relatively few cases of heel pain require more advanced treatments or surgery. If surgery is necessary, it may involve the release of the plantar fascia, removal of a spur, removal of a bursa, or removal of a neuroma or other soft-tissue growth.

Surgical Treatment

Usually, heel spurs are curable with conservative treatment. If not, heel spurs are curable with surgery, although there is the possibility of them growing back. About 10% of those who continue to see a physician for plantar fascitis have it for more than a year. If there is limited success after approximately one year of conservative treatment, patients are often advised to have surgery.

Prevention

There are heel spur prevention methods available in order to prevent the formation of a heel spur. First, proper footwear is imperative. Old shoes or those that do not fit properly fail to absorb pressure and provide the necessary support. Shoes should provide ample cushioning through the heel and the ball of the foot, while also supporting the arch. Wearing an orthotic shoe insert is one of the best ways to stretch the plantar fascia and prevent conditions such as heel spurs. Stretching the foot and calf is also helpful in preventing damage. Athletes in particular should make sure to stretch prior to any physical activity. Stretching helps prevent heel spurs by making tissue stronger as well as more flexible. In addition, easing into a new or increasingly difficult routine should be done to help avoid strain on the heel and surrounding tissue.

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