Heel Spurs & Plantar Fasciitis
Medical Author: William C. Shiel Jr., MD, FACP, FACR
Medical Editor: Dennis Lee, MD
What is a heel spur? What are symptoms of a heel spur?
A heel spur is a pointed bony outgrowth of the bone of the heel (the calcaneus bone). They are
attributed to local inflammation at the
insertion of soft tissue
tendons or fascia in the area.
Heel spurs can be located at the back of the heel or under the heel, beneath the
sole of the foot. Heel
spurs at the back of the heel are frequently associated with inflammation of the
Achilles tendon (tendinitis) and cause
tenderness and pain at the
back of the heel made worse while pushing off the ball of the
foot.
How do heel spurs relate to plantar fasciitis? What causes heel spurs and plantar fasciitis?
Heel spurs under the sole of the foot (plantar area) are associated
with inflammation of the plantar fascia (fasciitis), the "bowstring-like" tissue stretching underneath the sole that attaches at the
heel. Plantar heel spurs cause localized tenderness and pain made
worse when stepping down on the heel.
Heel spurs and plantar fasciitis can occur alone or be related to underlying diseases that
cause arthritis (inflammation of the joints), such as
reactive arthritis
(formerly called Reiter's disease), ankylosing spondylitis,
and diffuse idiopathic skeletal hyperostosis. It is important to note that heel spurs may cause no
symptoms at all and may be incidentally discovered during x-ray exams
taken for other purposes.
How are heel spurs and plantar fasciitis treated?
Heel spurs and
plantar fasciitis are treated by measures that decrease the associated
inflammation and avoid reinjury. Local ice applications both reduce pain and
inflammation. Antiinflammatory medications, such as ibuprofen or injections of
cortisone are often helpful. Orthotic devices or shoe inserts are used to take pressure
off plantar spurs (donut-shaped insert) and heel lifts can reduce
stress on the Achilles
tendon to relieve painful spurs at the back of the heel. Similarly, sports
running shoes with their soft, cushioned soles can be helpful in reducing
irritation of inflamed tissues from both plantar fasciitis and heel spurs.
Infrequently surgery is performed on chronically inflamed
spurs.
- A heel spur is a pointed bony outgrowth of the bone of the heel (the calcaneus bone).
- Heel spurs under the sole of the foot (plantar area) are associated with plantar fasciitis.
- Heel spurs and plantar fasciitis can occur alone or be related to underlying diseases.
- Heel spurs and plantar fasciitis are treated by measures that decrease the associated inflammation and avoid reinjury.
Last Editorial Review: 4/2/2008
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