A heel (or calcaneal) spur is a small build up of calcium on the calcaneus (heel) bone of the foot. When the back of the foot is subjected to ongoing pressure, calcium deposits can build up on the heel bone. This is not usually a problem, but over time, more deposits can develop on top of each other, forming a heel spur. Patients with heel spurs report pain in that region and a consequent difficulty in placing weight on the back of the foot. Heel spurs can be inferior, occurring underneath the heel, or posterior, forming at the back of the calcaneal bone, near the Achilles tendon.
Heel spurs are diagnosed by x-ray, which show the characteristic hook-shaped piece of bone on the heel. Heel spurs are most commonly seen in patients who suffer from plantar fasciitis (inflammation of the plantar fascia, or foot arch), particularly over a long period of time, but they are not uncommon even when this condition is absent. Obesity, childhood ankylosing spondylitis and the persistent wearing of high-heeled shoes are also predisposing factors for the development of a heel spur.
Plantar fasciitis and heel spurs are often written about as the same condition, but plantar fasciitis involves the tendon at the bottom of the heel, as opposed to a heel spur, which relates to the heel bone itself. Small calcium deposits can develop on the heel bone in response to tension and inflammation of the plantar fascia, which forms the bone spur. Interestingly, the bone spur itself is not what causes the pain, but is rather an indicator that the person has plantar fasciitis.
Chiropractic treatment of heel spurs usually consists of suggestions of ways to avoid exacerbating the condition and deep-tissue massage of fascial adhesions to release tension in the plantar fascia. Treatment with ultrasound and ice may also be used and exercises to stretch the muscles of the calf and plantar region of the foot may be recommended to help reduce the tension and inflammation causing the problem. In some cases, the leg may be splinted at night in order to further stretch the calf.
Good preventative and curative advice includes wearing supportive shoes rather than high-heels, avoiding running on hard surfaces and not going barefoot. Orthotic arch supports may also be advised for use with normal footwear, especially when plantar fasciitis is ongoing.
When pain is preventing walking and disturbing sleep, an analgesic medication may be used. In extreme cases, steroid injections and surgery may be necessary, but heel spurs usually respond well to conservative chiropractic treatment.