There are approximately 75 different causes of heel pain. At least 80% of all heel pain is due to heel spurs. A heel spur contains calcium, but cannot truly be called a calcium deposit. Bone spurs,
whether they are on the heel or on any other bone of the body, are true bone -- they are true enlargements of the bone and may be sharp and pointed, or round and knobby. Since bone spurs are true
bone, they contain calcium just like regular bones, but are not pure calcium deposits.
Heel spurs are common in patients who have a history of foot pain caused by plantar fasciitis. In the setting of plantar fasciitis, heel spurs are most often seen in middle-aged men and women, but
can be found in all age groups. The heel spur itself is not thought to be the primary cause of pain, rather inflammation and irritation of the plantar fascia is thought to be the primary problem. A
heel spur diagnosis is made when an X-ray shows a hook of bone protruding from the bottom of the foot at the point where the plantar fascia is attached to the heel bone.
The Heel Spur itself is not thought to be painful. Patients who experience pain with Plantar Fasciitis are suffering from inflammation and irritation of the plantar fascia. This the primary cause of
pain and not the Heel Spur. Heel Spurs form in some patients who have plantar fasciitis, and tend to occur in patients who have had the problem for a prolonged period of time. While about 70 % of
patients with plantar fasciitis have a heel spur, X-rays also show about 50 % of patients with no symptoms of plantar fasciitis also have a heel spur.
The diagnosis of heel pain and heel spurs is made by a through history of the course of the condition and by physical exam. Weight bearing x-rays are useful in determining if a heel spur is present
and to rule out rare causes of heel pain such as a stress fracture of the heel bone, the presence of bone tumors or evidence of soft tissue damage caused by certain connective tissue disorders.
Non Surgical Treatment
By reducing excessive motion and controlling and supporting the foot during physical activities an orthotic can help to limit how far the plantar fascia is pulled or torn away from the heel. A Heel
Spur pad can be offered- which is a pad designed to take pressure off the spur. If the problem persists, consult your foot doctor.
Approximately 2% of people with painful heel spurs need surgery, meaning that 98 out of 100 people do well with the non-surgical treatments previously described. However, these treatments can
sometimes be rather long and drawn out, and may become considerably expensive. Surgery should be considered when conservative treatment is unable to control and prevent the pain. If the pain goes
away for a while, and continues to come back off and on, despite conservative treatments, surgery should be considered. If the pain really never goes away, but reaches a plateau, beyond which it does
not improve despite conservative treatments, surgery should be considered. If the pain requires three or more injections of "cortisone" into the heel within a twelve month period, surgery should be