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by Scholten A
(Heel Spur; Bone Spur; Osteophyte)

Definition

A calcaneal spur (heel spur) is a bony growth on the heel of the foot. Heel spurs are common. Some heel spurs can break down tissue in the foot. They may also lead to corns and calluses.

Causes

Repeated strain and stress on the heel can cause a buildup of calcium deposits on the bone. Strain and stress on the heel are often caused by:

  • Long term muscle and ligament strains in the foot
  • Stretching of the planta fascia—a long band of tissue on the bottom of the foot

Risk Factors

Heel spurs are more common in older adults but anyone can get them. Other things that may raise the risk are:

  • Repeated running, dancing, or jogging on hard surfaces
  • Unsupportive, worn out, or poorly fitting shoes
  • Having certain health conditions such as:
    • Plantar fasciitis—inflammation of tissue on the bottom of the foot
    • Arthritis
  • Being overweight or obese
  • Walking gait defects that put too much pressure on tissues near the heel

Symptoms

Most heel spurs go unnoticed. Heel spurs that press on other bones or tissues can cause:

  • Pain in the bottom of the heel—may come and go
  • A hard bump, swelling, or warmth in the heel area

Diagnosis

The doctor will ask about symptoms and past health. A foot exam will be done. Heel spurs are often found during x-rays for other foot problems.

Treatment

Treatment is only needed if the heel spur is causing problems. The goal of treatment is to ease pain and inflammation.

Medicine, rest, and ice can help to ease pain and swelling. Flare ups may be reduced with other support steps such as:

  • A night splint—to keep muscles from tightening while sleeping
  • Taping stressed muscles and tendons—to let them rest
  • Supportive shoes and shoe inserts
  • Physical therapy to improve movement of the foot and ankle

Surgery may be needed if symptoms are severe or lasting. The bone spur will be shaved off. Soft tissue around it may also need repair.

Prevention

To lower the risk of heel spurs:

  • Wear the right shoes for sports and activities.
  • Wear shoes that fit well and are not worn out.
  • Warm up and stretch before doing activities.
  • Reach and keep a healthy weight.

RESOURCES

American Academy of Physical Medicine and Rehabilitation  http://www.aapmr.org 

OrthoInfo—American Academy of Orthopaedic Surgeons  http://orthoinfo.org 

CANADIAN RESOURCES

Ontario Podiatric Medical Association  http://www.opma.ca 

Orthogate  http://www.orthogate.org 

References

Bone spurs (osteophytes). Cleveland Clinic website. Available at: https://my.clevelandclinic.org/health/diseases/10395-bone-spurs-osteophytes. Accessed May 14, 2021.

Heel spur. UK HealthCare website. Available at: https://ukhealthcare.uky.edu/orthopaedic-surgery-sports-medicine/conditions/foot-ankle/heel-spur. Accessed May 14, 2021.

Menz HB, Thomas MJ, et al. Coexistence of plantar calcaneal spurs and plantar fascial thickening in individuals with plantar heel pain. Rheumatology 2019; 58(2):237-245.

Plantar fasciitis and bone spurs. OrthoInfo—American Academy of Orthopaedic Surgeons website. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/plantar-fasciitis-and-bone-spurs. Accessed May 14, 2021.

Plantar fasciitis. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/plantar-fasciitis. Accessed May 14, 2021

Rasenberg N, Riel H, et al. Efficacy of foot orthoses for the treatment of plantar heel pain: a systematic review and meta-analysis. British J Sports Med 2018;52:1040-1046.

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