Heel Conditions: Heel Spur Syndrome, what it is and how it's treated

Updated 10/8/2019

In this video Adrienne discusses her heel spur surgery and overall experience at University Foot and Ankle Institute.

Heel spurs are a condition that usually makes its presence known first thing in the morning via heel pain. Discomfort is typically felt in the front and bottom of the heel (calcaneal). Pain can be constant for several months or intermittent for lengthy periods of time.

 

UFAI is a world leader in the research and treatment of heel spurs with complete diagnostic services, non-surgical remedies and state-of-the art surgical options. 

 

Our foot and ankle specialists have decades of combined experience in the treatment of heel spurs and the highest success rates in the nation.

Heel Spur Symptoms and Causes

Most of the time heel spurs present as pain in the region surrounding the spur, which typically increases in intensity after prolonged periods of rest. Patients may not be able to bear weight on the afflicted heel comfortably. Running, walking, or lifting heavy weight may exacerbate the issue.

 

Generally caused by lack of flexibility in the calf muscles and/or excess weight, heel spurs occur when the foot bone is exposed to constant stress and calcium deposit build-up on the bottom of the heel bone. Repeated damage can cause these deposits to pile up on each other, presenting a spur-shaped deformity.


Diagnosing a Heel Spur

Diagnosis is made using a few different technologies. X-rays are often used first to ensure there is no fracture or tumor in the region. Then ultrasound is used to check the fascia itself to make sure there is no tear and check the level of scar tissue and damage. Neurosensory testing, a non-painful nerve test, can be used to make sure there is not a local nerve problem if the pain is thought to be nerve related.

 

It is important to remember that one can have a very large heel spur and no plantar fasciitis issues or pain at all, or one can have a great deal of pain and virtually no spur at all.

 

Heel Spur Treatment, Heel Spur Surgery

Heel Spurs vs. Plantar Fasciitis, What's the Difference?

Although a heel spur is often thought to be the source of heel pain, it rarely is. When a patient has plantar fasciitis, the plantar fascia pulls on the bottom of the heel bone. Over time this can cause a spur to form.  Heels spurs are a very common x-ray finding, and because the heel spur is buried deep in soft tissue and not truly in a weight bearing area, there is often no history of pain.

 

It is important to note that less than one percent of all heel pain is due to a spur, but frequently caused by the plantar fascia pulling on the heel.  Once the plantar fasciitis is properly treated, the heel spur could be a distant memory.  Learn more about Plantar Fasciitis here. 


Non-Invasive Heel Spur Treatment Options

Initially, treatment usually consists of a combination of home remedies such as ice therapy, stretching exercises to improve flexibility (especially in the mornings) and anti-inflammatory medications. Most patients will also need custom-molded orthotics to help control the motion in the foot and arch, which takes the strain off the plantar fascia. If the pain continues, a cortisone injection may be used to calm the severe swelling and pain. There may the need for a night splint to maintain a stretch in the plantar fascia throughout the night and physical therapy may be prescribed.

 

At University Foot and Ankle Institute we will try conservative and non-invasive treatments when a condition is in its early or “acute” phase. With a success rate of over 90%, a slow and steady course of treatment usually is just what the doctor ordered. 


Non-Surgical Treatment Options

Though conservative treatments for heel spurs work most of the time, there are some cases where we need to take your treatment to the next level. Luckily, with today’s technologies, you can still often avoid surgery.

 

Some of the advanced technologies we have to treat a Heel Spur are:

 

Platelet Rich Plasma Therapy

UFAI patient Barb discusses her heel spurs and how Platelet Rich Plasma Therapy has improved her life.

Platelet Rich Plasma Therapy (also known as PRP) is one of several regenerative medicine techniques that University Foot and Ankle Institute has helped bring to foot and ankle care.

 

This amazing in-office procedure allows the growth factors in the blood to be used to actually begin the healing process again long after your body has given up on healing the area. Learn more about Platelet Rich Plasma.

 

Heel Pain Shockwave Therapy

Shockwave therapy is a non-invasive procedure done in the office that allows for new blood to get to the region of fascia damage and help with healing. Results have been excellent with more than 70 percent of patients getting relief with only one treatment.

 

Topaz for Heal Spurs and pain

Another minimally invasive technology technique is called Coblation Surgery using a Topaz probe. This minimally invasive procedure involves controlled heating of multiple tiny needles that are inserted through the skin and into the plantar fascia. This process, like PRP and Shockwave therapy, irritates the fascia enough to turn a chronic problem back into an acute problem, greatly increasing the chances of healing.


Heel Spur Surgery

Endoscopic Plantar Fasciotomy is one surgical procedure that we consider to release the tight fascia. University Foot and Ankle Institute has perfected an endoscopic (camera guided) approach for fascia release to allow rapid healing and limited downtime with minimal pain. 

 

Frequently Asked Questions about Heel Spurs and Heel Spur Surgery

 

Q: Once a heel spur is removed, will it come back?

A: Yes, a heel spur can “technically” return, but that is really rare.

 

Q. For heel spurs, I was told that it is caused by the excess calcium deposit. In this case how can the Topaz procedure remove the excess calcium, because you have mentioned it will only remove the damaged tissue and not the calcium?

A. The heel spur is not the source of pain. The pain is from the scar tissue and damage to the plantar fascia insertion on the heel. We prefer a newer technique called hydrocision from TenJet.

 

Q: If I have a Heel Spur, does it always need to be removed?

A: No, a Heel Spur does not always have to be surgically removed. If it is causing no physical pain or harm, then there is probably no good reason to remove it since avoiding surgery whenever possible is the smartest way to go.

But if you have symptoms, it also does not mean you need to remove the spur. For example,  if the Heel Spur is on the bottom of the heel, it generally does not need to be removed and only a plantar fascia release would be necessary. But If the Heel Spur is on the back of the heel and the patient has Achilles Tendon problems, it very well may need to be removed. Surgical decisions are always made by us based on the individual patients physical condition and their lifestyle.

 

Have any Heel Spur questions we should add to our FAQ's? Let us know by clicking here.

 

 

 

  • Foot and Ankle Surgeon and Director of University Foot and Ankle Institute
    Dr Bob Baravarian, University Foot and Ankle Institute

    Dr. Bob Baravarian is a Board Certified Podiatric Foot and Ankle Specialist. He is currently a member of UCLA Medical Group, Chief of Podiatric Surgery at Santa Monica/UCLA medical center and Orthopedic Hospital and an assistant clinical professor at the UCLA School of Medicine. He also serves as Director of University Foot and Ankle Institute.

     

    Dr. Baravarian has been involved in athletics his entire life and played competitive tennis in high school and college. He has an interest in sports medicine, arthritis therapy and trauma/reconstructive surgery of the foot and ankle. He is also fluent in five languages (English, French, Spanish, Farsi and Hebrew),

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