Heel Spurs & Plantar Fasciitis
Medical Author: William C. Shiel Jr., MD, FACP, FACR
What are heel spurs?
Heel spurs are pointed bony outgrowths of the heel. They are attributed to local inflammation at the insertion of soft tissue tendons or fascia in the area. Heel spurs can be located at the back of the heel or under the heel, beneath the sole of the foot. Heel spurs at the back of the heel are frequently associated with inflammation of the Achilles tendon (tendinitis) and cause tenderness and pain at the back of the heel made worse while pushing off the ball of the foot.
How do heel spurs relate to plantar fasciitis?
Heel spurs under the sole of the foot (plantar area) are associated with inflammation of the plantar fascia (fasciitis), the "bowstring- like" tissue stretching underneath the sole which attaches at the heel. Plantar heel spurs cause localized tenderness and pain made worse when stepping down on the heel.
Heel spurs and plantar fasciitis can occur alone or be related to underlying diseases which cause arthritis (inflammation of the joints), such as reactive arthritis (formerly called Reiter's disease), ankylosing spondylitis , and diffuse idiopathic skeletal hyperostosis. It is important to note that heel spurs may cause no symptoms at all and be incidentally discovered during x-ray exams taken for other purposes.
How are heel spurs and plantar fasciitis treated?
Heel spurs and plantar fasciitis are treated by measures which decrease the associated inflammation and avoid reinjury. Local ice applications both reduce pain and inflammation. Antiinflammatory medications, such as ibuprofen or injections of cortisone are often helpful. Orthotic devices or shoe inserts are used to take pressure off plantar spurs (donut-shaped insert) and heel lifts can reduce stress on the Achilles tendon to relieve painful spurs at the back of the heel. Similarly, sports running shoes with their soft, cushioned soles can be helpful in reducing irritation of inflamed tissues from both plantar fasciitis and heel spurs. Infrequently surgery is performed on chronically inflamed spurs.
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