Heel Spur: Causes, Symptoms, Treatment and Cost

At the underside of the heel bone there is a bony growth known as heel spur. It usually develops as a result of excessive stretching or tearing of the plantar fascia ligament, which connects the heel to the toes. Heel spurs can cause pain and discomfort when walking and may even lead to more serious foot issues over time.

• Painful Heel Spur: At the underside of the heel bone there is a bony growth known as heel spur which causes pain when you walk or stand on it. These types of spurs are often associated with plantar fasciitis, Achilles tendonitis and other foot conditions caused by disease or injury.
• Non-Painful Heel Spur: Non-painful heel spur is usually hidden under a thick layer of muscle tissue on top of the bone and rarely causes discomfort or pain unless put under liquid nitrogen therapy or subjected to extreme stresses over an extended period of time. They can occur as a result of injury or prolonged wear on hard surfaces, such as concrete floors and sports courts.

• Heel spurs are caused due to constant, excess pressure and stretching of the plantar fascia ligament at the base of the foot.
• This pressure increases due to overuse from activities that put strain on the area like walking, running, jumping or standing for long periods of time.
• Factors that contribute to heel spur include obesity, poor fitting shoes and standing for long hours on a hard surface without proper arch support.
• Additionally, incorrect exercise form and repeated small microtraumas can lead to heel spur as well.

• Pain in the heel or the base of the foot is very sharp, intense and sometimes a burning sensation is felt too.
• Swelling around the heel area.
• Difficulty when flexing the foot and walking.
• Tightness in calf muscles due to tension on tendons on back of heel spurs.
• Achilles tendonitis and difficulty stretching.

• Maintain a healthy weight: Excess weight on the feet can increase the risk of heel spur.
• Change shoes often: Wearing supportive and well-constructed shoes, which fit properly, is important to prevent injury and heel spurs.
• Exercise regularly: Exercise helps keep muscles and tendons flexible and strong, reducing the chances of strain and injury.
• Take breaks regularly: Don't keep doing high intensity activities for long periods without a break.
• Wear Heel pads/Insoles: Padding or cushioning added to footwear can reduce impact from walking or running, decreasing the risk of irritation or inflammation in the plantar fascia or bone spur formation.

• Physical examination:A physical examination of the foot will often reveal tenderness and possible swelling at the point of the heel.
• X-rays:For the confirmation of the presence of a heel spur x-ray is used. X-rays will also be used to check for any damage or nerve irritation which may be caused by the spur.
• Ultrasound:An ultrasound scan is useful for showing blood flow within the foot, as well as detecting infections that could be causing pain in the heel area.
• CT Scan:The CT scan will be used to examine the heel in order to detect any underlying structural issues that may be contributing to the presence of a heel spur. The images produced by the scan will allow your doctor to assess the shape, size, and location of the spur and determine how much it is compressing on your bones or soft tissues.
• MRI:An MRI will give a detailed view of the foot, allowing for accurate diagnosis of foot problems including tendonitis or other soft tissue damage in addition to the presence of a heel spur.

• Pain and tenderness in the heel:A sharp, localised hip and calf pain is common when walking.
• Inflammation:Inflammation usually occurs in the area that has become excavated or damaged due to the presence of a heel spur.
• Difficulty walking:Difficulty walking or bearing weight on the heel can occur due to severe pain or tight calf muscles.
• Achilles Tendonitis:this is an inflammation of one of the tendons in your leg, which runs from your heel to right below your knee cap and can also cause pain with walking and standing activities.
• Plantar Fasciitis:This condition is characterised by an inflamed ligament under your foot running from your heel to toes, which causes difficulty with normal activities such as walking and running.

• Massage the affected area with warm coconut or sesame oil.
• Soak the area in warm water for 10-15 minutes multiple times a day.
• Apply a paste of crushed garlic and salt over the affected area twice a day.
• Prepare an herbal decoction by boiling triphala in water, and use it to soak the affected area twice a day for a maximum of 15 minutes each time.
• Drink ginger tea two to three times per day to reduce inflammation and cure heel spurs naturally.

• Foods that are high in anti-inflammatory properties, such as fruits, vegetables, fish and nuts, are recommended to help lessen heel pain caused by a heel spur.
• Include calcium-rich foods such as dairy products or supplements to help strengthen bones and muscles which can reduce heel pain.
• Foods with Vitamin C aid in collagen production which is necessary for healthy tendons and ligaments to help support the foot arch making it less prone to a heel spur forming.
• Protein-rich food sources like eggs, lean meats, beans or quinoa should also be part of an individual's diet with a heel spur to ensure proper tissue repair processes occur in the affected areas of the foot and ankle joint regions.

• Fried or Processed Foods:Fried and processed foods are high in unhealthy fats and calories and can contribute to inflammation that can cause heel spur pain.
• Sugary Foods:Sugary foods can further increase inflammation in the body which can worsen heel spur symptoms.
• Dairy Products:Dairy products are known to cause inflammation, so it’s best to stay away from them if you have a heel spur.
• Alcohol & Caffeine:Both alcohol and caffeine can aggravate tendon and ligament problems throughout the body, which may worsen your heel spur pain.

• Rest and ice packs:Rest is often recommended as an initial course of action because it helps reduce inflammation and allow healing to begin. Ice packs can also be used to reduce inflammation and help relieve pain associated with a heel spur.
• Stretching Exercises:Gentle stretching exercises can stretch tight muscles in your feet and calves to help ease pain related to heel spurs by improving flexibility in the muscles you use for walking, running, or standing for long periods of time.
• Orthotics:Custom orthotics can be prescribed by a doctor that fit into your shoe in order to support your arch or redistribute weight off of the sore areas of your feet while giving you added support while you walk or stand for long periods.
• Extracorporeal shock wave therapy:A non-surgical treatment that uses sound waves to reduce the pain associated with heel spurs.
• Cupping:A small, cupped incision is made in the heel bone to remove the spur and surrounding tissue.
• Excision:The spur is surgically cut out of the heel using a scalpel or tiny surgical instrument.
• Cryosurgery:The spur is frozen with liquid nitrogen until it breaks off the bone, usually leaving a small scar behind.
• Arthroscopy:Small cameras and instruments are used to remove the spur through very small incisions in the ankle or foot.
• Osteotomy:The affected area of the heel bone is cut and reshaped to relieve pressure built up from the formation of a spur.

It is best to visit an Orthopaedic doctor for expert diagnosis and treatment of Heel Spurs. An Orthopaedic specialist can make recommendations on various non-surgical and surgical treatments.

• Non-steroidal Anti-Inflammatory Drugs (NSAIDs): These drugs reduce inflammation and pain associated with heel spur. Examples include ibuprofen, naproxen and aspirin.
• Corticosteroid Injections: These are injections of cortisone, a powerful anti-inflammatory drug, into the affected area to reduce swelling and provide relief from pain.
• Topical medications: Topical creams and gels containing ingredients such as capsaicin help block painful signals from the nerve endings and provide temporary relief from discomfort associated with heel spur pain.

Healing time can depend on the cause and severity of the discomfort.

Generally, it can take between 6 and 12 weeks to heal, if treated properly with rest, icing, stretching, and occasionally orthotic inserts.

Proper support and pain relief may help alleviate symptoms and speed up recovery.

Surgery may be necessary in rare cases of chronic discomfort that does not heal with these treatments.

• The results of treatment for heel spurs are usually permanent.
• Treatment options such as orthotics and shoe inserts can improve biomechanics in the feet, leading to a complete resolution of symptoms associated with the heel spur.
• However, while rest and stretch exercises may reduce inflammation and pain caused by the condition, it may not completely cure the heel spur itself.
• If symptoms relapse after a period of time, further evaluation may be needed to investigate any underlying causes that might be leading to the recurrence.

• Rest:Avoid physical activities and give the affected foot adequate rest to allow it to heal.
• Ice:Apply ice packs or cold compresses to reduce swelling, pain, and inflammation in the affected area.
• Medication:Over-the-counter nonsteroidal anti-inflammatory medications (NSAIDs) such as ibuprofen can help relieve heel pain and swelling.
• Compression:Wear a night splint or use specialised shoe inserts that help support the arch of your foot and keep pressure off the heel spur.
• Supportive Footwear:Wear shoes that provide cushioning and shock absorption to reduce stress on your feet when walking or running.
• Exercise Therapy:Strengthen lower leg muscles with calf raises, stretching exercises, hamstring stretches, Achilles tendon stretching exercises, etc., to reduce load on the heel spur area and promote healing.

The cost of treating heel spurs in India usually ranges from ₹2,000 to ₹15,000 depending on the severity of the condition. The cost may include various tests, medications, imaging scans and surgeries if required.

Common side effects of heel spur treatments may include:

• Pain and swelling at the site of treatment or injection.
• Bruising at the site of treatment or injection.
• Localised redness at the site of treatment or injection.
• Allergic reaction to medication and materials used in the treatment.
• Infection
• Nerve damage.

If you are going through any of the complications related to heel spur kindly consult a doctor of your nearby as if not treated on time they can cause complications like 'difficulty walking, achilles tendonitis, plantar fasciitis' in which treatment course can vary from months to years depending on the severity of the of the patient's situation.