A heel spur is a hook of bone that can form on the heel bone (calcaneus).
The terms heel spur and plantar fasciitis are often confused. While these two diagnoses are related, they are not the same. The diagnosis of heel spurs can be confused with tarsal tunnel syndrome. Heel spurs are common in patients who have a history of foot pain caused by plantar fasciitis.
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 plantar fascia is the thick, connective tissue that runs from the calcaneus (heel bone) to the ball of the foot. This strong and tight tissue helps maintain the arch of the foot. It is also one of the major transmitters of weight across the foot as you walk or run. In other words, tremendous stress is placed on the plantar fascia.
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.
Treatment of heel spurs is the same as treatment of plantar fasciitis.
To arrive at an accurate diagnosis, our foot and ankle Chartered Physiotherapists will obtain your medical history and examine your foot. Throughout this process the physio will rule out all the possible causes for your heel pain other than plantar fasciitis.
The following treatment may be used:
Orthotics / Insoles: Where there are biomechanical causes to Plantar Fasciitis and Heel Spur, our Physios will complete a full biomechanic assessment and Gait Scan to determine with accuracy the cause. Depending on the results, we may prescribe either off the shelf corrective insoles or customised orthotics, which we manufacture bespoke for you using our Gait Scan technology. Custom orthotic devices that fit into your shoe help correct the underlying structural abnormalities causing the plantar fasciitis and heel spur. We are Ireland’s largest provider of Customised Orthotics and our Chartered Physiotherapists are specifically trained in treatment of Plantar Fasciitis. For full details on this service, click here
Inflammation reduction: Physiotherapy, may be used in conjunction with the above or as a standalone treatment to reduce local inflammation.
Mobilisation: Stiff joints around the foot and ankle can be treated using mobilisation, where our Physios gently moves the joints manually to remove the stiffness and restore the normal range of movement.
Taping and Strapping: Taping and strapping has been shown to be an effective treatment for Plantar Fasciitis. The tape supports the Plantar Fascia and removes some of the strain that can aggravate the condition.
Rest: In most sporting individuals the cause is overuse and the most important advice is to allow adequate rest, to take the strain off the Plantar Fascia and allow the affected tissues time to heal.
No matter what kind of treatment you undergo for plantar fasciitis, the underlying causes that led to this condition may remain. Therefore, you will need to continue with preventive measures. Wearing supportive shoes, stretching, and using custom orthotic devices are the mainstay of long-term treatment for plantar fasciitis.
When Is Surgery Needed?
Surgery for plantar fasciitis is extremely rare and should be considered when all else has failed and the condition is affecting your quality of life.
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Treatment for heel spur is offered at the following clinics.