Plantar Calcaneal Spur- Causes and Symptoms

A calcaneal spur is a bony projection or outgrowth that forms on the undersurface or back of the calcaneus, the largest tarsal bone that constitutes the human heel. The calcaneus is commonly known as heel bone, and bony outgrowths that develop on it are known as heel spurs.

Heel spurs can occur at the back or underside of the heel bone. When heel spurs develop under the sole or where the plantar fascia connects to the heel bone, they are called plantar calcaneal spurs. The presence of bone spurs in the heel can cause pain while walking, which can be confused with the pain associated with plantar fasciitis.

Plantar fasciitis is the condition characterized by the inflammation of the plantar fascia, the band of fibrous tissue that runs along the sole of the foot and connects the heel bone to the toes. It radiates from the heel like a fan, and helps maintain the arch of the foot.

Basically, heel spurs are nothing but calcium deposits that develop due to the excessive pressure placed on the foot, or the foot muscles and ligaments. Bone spurs can form in response to an injury. The body tries to repair the injury or damage by growing extra bones on the edges of the existing bones, which can cause the formation of bone spurs.

Though what exactly causes heel spurs is not known, several possibilities have been put forwarded over the years. One such supposition is that heel spurs that form on the underside of the heel, where the plantar fascia connects to the heel bone, can be associated with the condition, plantar fasciitis.

Plantar fasciitis is characterized by the inflammation of the plantar fascia, the layer of fibrous tissue present on the underside of the foot. Plantar fasciitis can cause excessive pulling of the outer layer of the calcaneus, or the periosteum. Excessive pressure placed on the periosteum over extended periods of time can eventually cause bone spurs.

In general, it has been observed that obese or overweight people, and people having a very high arch or flat foot are more likely to develop this condition. The same has been observed for women who wear high-heeled shoes constantly.

High-heeled shoes and shoes that cannot provide proper support to the arch can predispose an individual to develop heel spurs. Heel spurs are quite common in athletes and sportspersons as well.

Gait and balance abnormalities can also increase the risk of developing this condition, if more pressure is placed on the heel bones and the adjoining ligaments while walking. Walking or standing on a hard surface for a long time can place excess pressure on the feet and the heel bones.

Repeated tearing of the membrane that covers the heel bone, and overstretching of the plantar fascia can also cause bone spurs on the heel.

Heel spurs, including the plantar calcaneal spurs, may not cause pain at times. Sometimes, they can cause a sharp and stabbing pain, especially when the affected individual stands on his feet in the morning after getting up from the bed. Additionally, the calf muscles can feel stiff in the morning.

The pain caused by this condition is reported to be similar to the pain caused by a pin sticking to the bottom of the heel. The pain can be intermittent or chronic, and it can aggravate while walking or running, especially on a hard surface. The pain caused by heel spurs can resolve after lying down, and then return after getting up.

The treatment of heel spurs depends on the severity of the condition. This condition is diagnosed with the help of physical examination and imaging tests like X-rays. Heel spurs actually do not cause pain. But they can press against the adjacent muscles and the ligaments while walking or standing, which can cause a soft tissue injury and pain.

The treatment options available for this condition are explained below:

Medications
To manage the pain, your physician can recommend anti-inflammatory medications after evaluating the condition. If the pain and inflammation are too severe to be managed with these medications, your physician can prescribe steroid injections.

However, steroids are usually not used for treating this condition due to the possible side effects associated with these drugs. Anesthetic injections are usually used when the pain caused by heel spurs becomes intolerable. If the pain is not severe, ice packs applied for 10 to 15 minutes at a time can also provide significant relief.

Night Splints
We normally keep the feet pointed down while sleeping, which relaxes the plantar fascia. But in the morning, when we get up and stand on our feet, the plantar fascia stretches, which in turn produces the sharp, stabbing pain in the heel.

Night splints can help stretch the plantar fascia while sleeping, which in turn can reduce the sharp intense pain experienced in the morning.

Supportive Shoes and Orthotics
You can also use shoe inserts or heel cups to cushion your heel. Your physician can recommend special footwear that can provide adequate support to the heel and the sole of the feet. Shoes having thick soles and extra cushioning can help reduce the pain caused by heel spurs while standing or walking.

Physical Therapy
Physical therapy can include an appropriate exercise program to strengthen the calf muscles and the plantar fascia. Calf stretch and plantar fascia stretch can be extremely helpful in this regard.

Along with these exercises, your physical therapist can recommend specialized ice treatments and massage to relieve the pain and inflammation around the plantar fascia.

Surgery
If conventional non-surgical treatment options fail to manage the pain caused by plantar calcaneal spurs, surgery can be required to loosen the plantar fascia and remove the bone spur. Surgery can also be required if the bone spur is quite large in size.

It is possible to prevent plantar fasciitis and heel spurs by:

➟ Wearing properly-fitting and comfortable shoes that can provide adequate support to the feet and the heels. Shoes having shock-absorbent soles and supportive heels are ideal.

➟ Choosing appropriate shoes for different types of physical activity.

➟ Doing stretching exercises or warming up before a workout session.

➟ Losing weight if you are obese. Excessive body weight can place more pressure on the heel bone while standing or walking.

➟ Avoiding tight-fitting and high-heeled shoes, and shoes having excessive wear on the heels.

It is possible to prevent the development of calcaneal spurs by following the aforementioned preventive measures. Surgery is rarely used for treating this condition. It is opted only when physical therapy and other conservative efforts fail to manage the pain and discomforts caused by plantar calcaneal spurs.

Disclaimer: This story is for informative purposes only, and should not be treated as a substitute for professional medical advice.