| How do I know if my foot pain is being caused by a calcaneal spur?
A calcaneal spur (or heel spur) can cause sharp, immobilizing pain in back of the heel bone (calcaneus) or under the heel bone. Although the pain tends to subside when we rest, it can be especially intense when we begin to walk after periods of rest. If we then continue to walk despite the pain, it will likely begin to subside again. |
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| View film about calcaneal spurs and plantar fasciitis
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Calcaneal spurs do not appear out of the blue.
Calcaneal spurs under the heel bone usually arise in connection with prolonged stress and slight, but recurring injuries to the tendons of the foot at the point of their attachment to the heel bone. Calcification and the appearance of spurs that project forward from the heel bone constitute a reaction on the part of the body to this stress. Uneven weight bearing (e.g. as a result of wearing the wrong shoes) and cramped positions maintained for prolonged periods (e.g. when driving long distances) can cause the micro-injuries that lead to the development of spurs.
Spurs are usually visible as small bony projections on x-rays (taken from the side). As the spurs continue to grow, they exert even greater pressure and can ultimately trigger a process of inflammation in the plantar fascia. It is actually this inflammation that causes the sharp pain.
Diagnosing Calcaneal Spurs
The diagnosis of calcaneal spurs is initially based on clinical examination and the answers patients provide to the questions posed by their doctors. Preliminary diagnoses can then be supported by methods of visualization, such as x-rays and ultrasound.
Ultrasound in particular will allow your doctor to measure the thickness of the plantar fascia and use this measurement to monitor your progress once treatment begins. Successful treatment involves the reduction and elimination of the inflammation. It is always essential to rule out the possibility of other disorders before introducing treatment for calcaneal spurs.
Forms of Treatment for Calcaneal Spurs
Treatment for calcaneal spurs usually begins with a combination of conservative measures. Should these measures fail to bring about a gradual improvement in the condition, then it may become necessary to introduce an invasive form of treatment.
Conservative Forms of Treatment
- Shoe inserts that distribute weight away from the point of inflammation
- Shoe inserts to support the arch
- Padding for the heel
- Ultrasound
- Phonophoresis
- Iontophoresis
- Local cryotherapy (ice massage)
- Stretching of surrounding muscles and tendons
- Medication
- Local infiltration with homeopathic substances
- Local cortisone infiltration
Invasive Forms of Treatment
- Extracorporeal shockwave lithotripsy (shockwave treatment)
- Endoscopic, minimally invasive calcaneal spur removal
The above-mentioned forms of therapy can be regarded as complementary or successive. Our clinical experience suggests that shockwave therapy is often the safest and most effective way of lastingly eliminating the pain and its cause. The endoscopic removal of calcaneal spurs proves necessary only in exceptional cases.
