It is an overgrowth of calcaneal bone, which forms the heel on the back of the sole of the foot. The excess bone is shaped like a spear.
It can be caused by inflammation following repeated microtrauma to the plantar fascia that inserts into the heel. Factors favouring inflammation of the plantar fascia include age, overweight, rheumatic diseases that favour the accumulation of substances, postural problems and increased repetitive physical activity. Safety shoes for work, high heels or hard-soled shoes can intensify symptoms.
Many people with heel spurs are completely asymptomatic. When they do develop symptoms, it is with severe heel pain and lameness. Typically, the lameness subsides or even disappears shortly after starting to walk, only to reappear after a period of activity.
Diagnosis is made through medical history, physical examination and imaging tests such as X-ray, magnetic resonance imaging or ultrasound of the foot.
It is treated with insoles that slightly elevate the heel and relieve the area of tension. Analgesics and anti-inflammatory drugs can be used to reduce pain. In cases resistant to conservative treatment, surgical treatment can be used, although it does not always eliminate the pain and can lead to complications.
- Rachelle Buchbinder, MBBS, MSc, PhD, FRACP. Plantar fasciitis. Uptodate. May 05, 2017.
- Riddle DL, Schappert SM. Volume of ambulatory care visits and patterns of care for patients diagnosed with plantar fasciitis: a national study of medical doctors. Foot Ankle Int 2004; 25:303. L.
- JE, Ryan MB, Clement DB, et al. A retrospective case-control analysis of 2002 running injuries. Br J Sports Med 2002; 36:95.
- Riddle DL, Schappert SM. Volume of ambulatory care visits and patterns of care for patients diagnosed with plantar fasciitis: a national study of medical doctors. Foot Ankle Int 2004; 25:303.
