Heel spur: diagnosis and treatment

Heel spur, also called plantar fasciitis, is a common disease that occurs in a chronic form. It is the result of microtrauma in the plantar ligament area. Patients complain of severe debilitating pain, which is the result of growing bone formations. An osteophyte in the form of a pointed spike, reaching a length of 12 mm, begins to compress nearby soft tissue. The pathology can develop outwardly imperceptibly at the first stage. However, identifying a neoplasm is quite simple - you just need to press on individual areas of the heel.

Symptoms of heel spurs

At the initial stages of the development of the disease, it does not manifest itself in any way and can be practically asymptomatic. As the inflammatory process progresses and the bone spine grows, the patient may experience complaints:

Pain while walking or exercising. Gradually, unpleasant sensations begin to appear with any, even the slightest, load on the affected heel.
According to patient descriptions, the pain resembles the sensation of a nail or needle in the heel; it is acute and depends on the degree of growth of the bone spine.
Sharp pain after a night's rest. As the person moves, it gradually subsides.
Over time, scar tissue forms around the heel spur, in which calcium salts are deposited and osteophyte bone spines begin to grow. This is manifested by the appearance of pain at rest.
As the disease progresses, the patient's gait changes. This is due to the fact that he is trying to spare the injured leg and reduce the load on it. Constant transfer of body weight from the heel to the other part of the foot can lead to the formation of transverse flatfoot. Thus, a heel spur can significantly impair normal life activities and become a serious obstacle to work and sports.
Externally, the disease does not have pronounced manifestations; sometimes there may be slight swelling of the heel and the appearance of a callus.

How does pathology develop?

The plantar fascia is a fibrous tissue, a ligament that connects the heel bone to the metatarsal bones at their heads. The ligament helps maintain the longitudinal arch of the foot.

As a person moves, the area of fascial tissue is subjected to intense tension. It manifests itself to the greatest extent precisely in the place where it is attached to the tubercle of the calcaneal localization. It is therefore not surprising that damage can occur under high loads. However, in a normal state in a healthy person, healing of microtraumas of the plantar ligament occurs quite quickly. The recovery process does not require external intervention - it proceeds naturally.

The greatest danger lies in regular, permanent damage. The result of this is the restructuring of the periosteum, right down to the bone tissue.

The development of planar fasciitis is associated with:

microtrauma of the ligaments at the point where they are attached;
progression of aseptic, not related to the action of microbial agents, inflammatory changes in the area of damage;
irritating effect on the periosteum of the heel bone due to high loads.

In places where inflammatory processes occur, calcium salts are deposited and accumulated. This causes the formation of osteophyte, i.e. heel spurs. Studies conducted using X-rays and diagnostic magnetic resonance procedures confirm the localization of 40% of neoplasms in the fascial plane. Moreover, about half of the manifestations occur in the zone above it.

The main structural provocateurs of this disorder are the muscles that play the role of flexors in the area of the fingers on the lower extremities. In this case, a special feature is the possibility of spurs forming not only on one, but also on both heels.

Diagnosis of heel spurs

Diagnosis of the disease, as a rule, does not cause difficulties. In order to suspect a heel spur, the doctor only needs to evaluate the patient’s complaints: pain in the heel area, especially after a night’s sleep and physical activity. During the examination, the orthopedist palpates the patient’s foot and assesses the location and severity of the pain syndrome. To confirm the diagnosis, instrumental studies are prescribed, primarily radiography. From the photographs, the doctor can assess the size and location of the thorn. In the early stages of the development of the disease, the formation has a round shape, gradually it takes the form of a bird's beak and can exceed 1 cm in size. In severe cases, the orthopedist prescribes an MRI, which allows one to assess the condition of the soft tissues around the heel spur. Ultrasound is not an informative and necessary method for diagnosing heel spurs, but is used to monitor the progress and result of treatment.

Causes of the disease

The number of diagnosed cases of heel spurs in patients is constantly increasing. Every year, over 2 million people visit medical institutions complaining of such problems. The majority of patients (about 70-80%) are women and live in urban areas. The average age of patients is 50 years.

Doctors tend to consider several main reasons for the appearance and development of a tumor:

1. The presence of a pathology such as flat feet. Up to 90% of diagnosed cases of osteophyte and its subsequent growth are associated with this pathology.

2. Processes of age-related changes in the body. As a person ages, deviations in circulatory processes and in the condition of the lower extremities become more pronounced. Patients often experience a decline in the regenerative abilities of tissues.

3. Pregnancy status.

4. Poor weight control and accumulation of extra pounds. With obesity, the load on the foot area increases sharply, especially during movement.

5. Injury, the presence of pathologies and diseases of the tissues, nervous and vascular systems in the lower extremities. For example, we are talking about gout, diabetes, rheumatoid arthritis and other ailments.

Young people are forced to deal with the growth of the tumor due to an overly intense training process and wearing uncomfortable shoes, including flip-flops and high-heeled models.

Heel spur treatment

Complex treatment of heel spurs consists of several points: reducing the load on the foot, drug treatment and instrumental therapy

Reducing physical stress on the foot includes:

Semi-bed rest during acute periods of illness
Reducing the duration of walking and standing, frequent rest breaks during walks, mandatory use of special insoles
An individually selected complex of physical therapy with mandatory taping, that is, fixation of the heel fascia with a special sports tape-plaster
Use of orthoses at night - special devices that hold the leg in a position at a right angle. This allows you to significantly reduce or completely eliminate the symptom of morning pain
The use of orthopedic insoles and, if necessary, special devices in the form of a cane or crutches when walking

Presence of spurs in children

Heel tumors can also occur in young patients. Moreover, the cause is standard factors - flat feet, excessive body weight, injury, diseases of the musculoskeletal system, infectious lesions. The problem is complicated by the anatomy of the child's foot. Until the age of 18, it is excessively elastic and subject to rapid deformation.

The treatment method is selected taking into account the age characteristics of the patient and the severity of the disease. Usually doctors limit themselves to conservative therapy. The effectiveness of treatment depends on correct identification of the disease. The main signs of the disease are pain in the heel, disturbances in gait or posture, and problems with decreased motor activity. Parents need to constantly monitor the condition of their child’s feet. It is important to exclude calluses, ingrown toenail syndrome, and bruises, which can lead to deformities and injuries.

Shoes for a child should be selected individually according to age. Booties are suitable only for the smallest children who do not yet walk, but at the beginning of physical activity, preference should be given to shoes with leather soles and 1 cm heels. Shoes should be clearly fixed on the leg. It is important to completely avoid wearing flip-flops and flip-flops. Ballet flats and sneakers are not suitable for frequent wearing. You should be careful when using used shoes. After all, each child tramples the insole and wears out the sole in his own way.

Drug treatment of heel spurs

To reduce inflammation and pain, non-steroidal anti-inflammatory drugs (NSAIDs) can be prescribed externally and internally in a short course. Long-term therapy is fraught with complications from the gastrointestinal tract. For severe inflammation and severe pain, local injections of glucocorticoid hormones may be prescribed. In the absence of an effect from such treatment, drug blockades are prescribed to reduce or completely relieve pain. The drug is injected directly into the affected area, which allows you to achieve good results. However, it is important that the procedure is performed by an experienced and competent orthopedist. Otherwise, there is a risk of complications. Physiotherapy is prescribed in combination with medications. For heel spurs, the following are used: magnetic therapy, electrophoresis, paraffin baths, mud and radon baths.

Surgical treatment of heel spurs

If conservative methods do not help get rid of the problem, then it is necessary to resort to surgical treatment. During the operation, an incision is made in the area of the spur, the existing growth is removed, and the tissue is sutured. Currently, the most common method of surgical intervention is endoscopic dissection of the fascia. Through a small incision, the doctor inserts a special device - an endoscope, with which he cuts the fascia and removes the spur. The procedure is often performed under X-ray guidance to minimize complications and maximize the effect of the operation. Instrumental methods have worked well in the treatment of heel spurs.

Treatment at home

Doctors insist that using traditional methods of treatment without consulting a specialist can harm the patient. Therefore, before using such recipes, you must definitely visit a doctor.

Recipe 1. Heat the alcohol in a frying pan and then pour it into a bowl. You need to keep your heels in this container for at least 10 minutes. There is no need to wipe your feet after the procedure.
Recipe 2. Mix 50 g of animal bile (fish or poultry product is not used) with 30 g of shampoo. The night before bed, steam your heels and then apply the mixture. After this, you should wrap your feet in a scarf and put on warm wool socks.
Recipe 3. Pain from large spurs is eliminated with compresses from a nettle mixture. The plant is harvested in May and passed through a meat grinder. The mixture is used to prepare a compress. It is applied to the damaged area and covered with a burdock leaf. A bandage is used for fixation. The procedure is performed before bedtime and is carried out for at least 2 weeks.
Recipe 4. Use 200 g of pre-washed iris roots. They are passed through a meat grinder and filled with alcohol. The mixture should be infused in a dark, dry place for 2 weeks. Cotton wool soaked in the tincture is applied to the heel and fixed with a bandage overnight.
Recipe 5. Spread the spur with buckwheat honey and cover this layer with dough. Put a wool sock on top. The compress is worn for several days and then renewed. Course of treatment – 1 month.
Recipe 6. Laundry soap weighing 100 g is grated and then melted. The compress is applied to the spur at night. The procedure is repeated every day.
Recipe 7. Felt boots are needed for 20 minutes. Before going to bed, rub the damaged area. Duration of treatment is up to 1 month.

These treatment methods can only be auxiliary and complement the course of traditional therapy. This requires consultation with a doctor who can correctly diagnose the cause of the pathology.

Shock wave therapy for heel spurs

The basis of the treatment, as the name suggests, is the impact on the heel spur with special low-frequency acoustic shock waves. They reduce pain, destroy calcifications, stimulate metabolism and eliminate the inflammatory process. The procedure takes no more than half an hour and is carried out once every few days. The full course of treatment is 5-7 sessions. The advantages of shock wave therapy for heel spurs are the absence of discomfort during the procedure, high efficiency and gradual destruction of areas of “salt deposits”. The procedure is contraindicated for adolescents under 18 years of age, pregnant women, patients with thrombophlebitis, acute infectious diseases and low blood pressure.

Diagnosis of emerging disorders

To effectively treat the disease and exclude the possibility of complications, a timely diagnosis is required. This cannot be done solely based on external examination and descriptions of the pain syndrome. The reason is that the sensation of pain in the heel area may be due to the development of other pathological abnormalities. These include:

ankylosing spondylitis;
gout;
rheumatoid type arthritis;
osteomyelitis;
tuberculous lesions of bone tissue;
injury, including tendon sprains, bruises;
inflammatory changes in the foot area;
infectious processes, including intestinal and urogenital.

The basic step in making a diagnosis is taking an anamnesis. However, correct diagnosis is impossible without a number of laboratory and instrumental studies. Doctors prescribe a general and biochemical blood test, a urine test, an X-ray examination and an MRI of the foot.

The goal of all diagnostic procedures is not only to make a correct diagnosis, but also to identify the cause of the disease and assess the severity of its course. If a patient has concomitant diseases, the doctor often prescribes consultative examinations with relevant specialists.

X-ray therapy for heel spurs

With this treatment option, the heel spur is exposed to x-rays. The procedure allows you to block nerve endings, which in turn helps eliminate pain. The advantages of the method include painlessness and short session duration, as well as a combination of analgesic and anti-inflammatory effects. Contraindications to the procedure include: pregnancy and breastfeeding, exhaustion, blood diseases, severe pathologies of internal organs.