What Is A Posterior Calcaneal Spur

Overview


Heel spur (Calcaneal spur) is a bonny outgrowth of the heel bone which is pointy in shape. It?s a calcium deposit that happens under the heel bone. In some cases, the protrusion due to heel spur can extend up to half inch and can be seen in X rays. Generally it is painless but sometimes it may result in heel pain. Heel spur that occur under the sole of the foot or the planter area is associated with plantar fasciitis. That is frequently associated with plantar fasciitis as they have many similarities.


Causes


Bone spurs can form anywhere in the feet in response to tight ligaments, repetitive stress injuries (typically from sports), obesity, even poorly fitting shoes. For instance, when the plantar fascia on the bottom of the foot pulls repeatedly on the heel, the ligament becomes inflamed, causing plantar fasciitis. As the bone tries to mend itself, a bone spur forms on the bottom of the heel, typically referred to as a heel spur. This is a common source of heel pain.





Symptoms


You may or may not experience any symptoms with your heel spurs. It is normally the irritation and inflammation felt in the tissues around your heel spur that cause discomfort. Heel pain is one of the first things you may notice, especially when pushing off the ball of your foot (stretches the plantar fascia). The pain can get worse over time and tends to be stronger in the morning, subsiding throughout the day; although it does return with increased activity. A sharp, poking pain in your heel that feels like you're stepping on a stone can often be felt while standing or walking. You will sometimes be able to feel a bump on the bottom of your heel, and occasionally bruising may appear.


Diagnosis


A thorough medical history and physical exam by a physician is always necessary for the proper diagnosis of heel spurs and other foot conditions. X rays of the heel area are helpful, as excess bone production will be visible.


Non Surgical Treatment


Heel spurs can be treated by wearing orthotic insoles inside the shoe. Orthotics are designed to correct incorrect gait, in particular over-pronation (rolling in of the foot and collapsing of the arches). Over-pronation is a very common foot condition, affecting at least half of the population. It is a major contributing cause of heel spurs. Orthotics are very effective in that the device corrects the foot to its natural position. By supporting the arches properly and preventing excess rolling in of the foot, the plantar fascia is placed under much less strain and stress compared to an unsupported foot. Less strain on the ligament means less pulling away from the heel bone, allowing the inflammation to heal faster. In addition to orthotic treatment, most podiatrists and physiotherapists recommend a series of exercises to help make the ligaments in the feet and legs longer and more flexible. In turn this will help reduce strain on the plantar fascia.


Surgical Treatment


Most studies indicate that 95% of those afflicted with heel spurs are able to relieve their heel pain with nonsurgical treatments. If you are one of the few people whose symptoms don?t improve with other treatments, your doctor may recommend plantar fascia release surgery. Plantar fascia release involves cutting part of the plantar fascia ligament in order to release the tension and relieve the inflammation of the ligament. Sometimes the bone spur is also removed, if there is a large spur (remember that the bone spur is rarely a cause of pain. Overall, the success rate of surgical release is 70 to 90 percent in patients with heel spurs. One should always be sure to understand all the risks associated with any surgery they are considering.

What Is The Most Effective Answer To Posterior Calcaneal Spur

Overview


A heel spur is a calcium deposit causing a bony protrusion on the underside of the heel bone. On an X-ray, a heel spur can extend forward by as much as a half-inch. Without visible X-ray evidence, the condition is sometimes known as "heel spur syndrome." Although heel spurs are often painless, they can cause heel pain. They are frequently associated with plantar fasciitis, a painful inflammation of the fibrous band of connective tissue (plantar fascia) that runs along the bottom of the foot and connects the heel bone to the ball of the foot. Treatments for heel spurs and associated conditions include exercise, custom-made orthotics, anti-inflammatory medications, and cortisone injections. If conservative treatments fail, surgery may be necessary.


Causes


Bone spurs form in the feet in response to tight ligaments, to activities such as dancing and running that put stress on the feet, and to pressure from being overweight or from poorly fitting shoes. For example, the long ligament on the bottom of the foot (plantar fascia) can become stressed or tight and pull on the heel, causing the ligament to become inflamed (plantar fasciitis). As the bone tries to mend itself, a bone spur can form on the bottom of the heel (known as a ?heel spur?). Pressure at the back of the heel from frequently wearing shoes that are too tight can cause a bone spur on the back of the heel. This is sometimes called a ?pump bump,? because it is often seen in women who wear high heels.





Symptoms


Although it may take years to become a problem, once it appears, it may cause considerable suffering. Because of proximity to the tendons, the spur is a source of continuous painful aching. The sensation has been described as "a toothache in the foot." When you place your weight on the heel, the pain can be sufficient to immobilize you.


Diagnosis


A thorough history and physical exam is always necessary for the proper diagnosis of heel spurs and other foot conditions. X rays of the heel area are helpful, as excess bone production will be visible.


Non Surgical Treatment


Perform some exercises. Exercises that strengthen and lengthen your plantar fascia can also be very helpful for heel spurs. Try some of the following activities. Calf stretch. Place your hands on a wall. Extend 1 foot (0.3 m) behind you with your knee straight and place the other foot in front of you with the knee bent. Push your hips toward the wall and hold the stretch for 10 seconds. You should feel a pull in your calf muscles. Repeat the stretch 20 times for each foot. Plantar fascia stretch, Perform this exercise in the morning before you've done any standing or walking. Cross your injured foot over the knee of your other leg. Grasp your toes and gently pull them toward you. If you can't reach your toes, then wrap a towel around them and pull on the towel. Hold the stretch for 10 seconds and repeat 20 times for each foot.


Surgical Treatment


Surgery involves releasing a part of the plantar fascia from its insertion in the heel bone, as well as removing the spur. Many times during the procedure, pinched nerves (neuromas), adding to the pain, are found and removed. Often, an inflamed sac of fluid call an accessory or adventitious bursa is found under the heel spur, and it is removed as well. Postoperative recovery is usually a slipper cast and minimal weight bearing for a period of 3-4 weeks. On some occasions, a removable short-leg walking boot is used or a below knee cast applied.


Prevention


You can help prevent heel spur symptoms from returning by wearing the proper shoes. Customized orthotics and insoles can help relieve pressure. It is important to perform your exercises to help keep your foot stretched and relaxed.