The heel bone or calcaneus is the largest bone in the foot and projects backward beyond the leg bones to provide a useful lever for the muscles of the calf. It bears all of the body’s weight with each step. The stress placed on the heel bone and its associated structures is tremendous and makes it susceptible to what is known as plantar fasciitis or heel spur syndrome. The pain that results from these disorders is caused by the inflammation at the plantar fascia and heel bone. The plantar fascia is a the long band of fibers attached at the bottom of the heel bone. It also helps create the arch of the foot.
Plantar fasciitis and heel spur syndrome are usually the result of biomechanical faults. Biomechanical faults refer to such abnormalities as flexible flat feet, high-arched foot deformities and a tight Achilles tendon. These disorders place a greater amount of stress on the plantar fascia.
Other causes of stress on the heel and plantar fascia include recent weight gain, high-impact athletic activities, prolonged standing or walking, trauma, lower back problems and arthritis.
TREATMENT
Your doctor will schedule appropriate lab tests, X-rays and advanced imaging studies, if necessary. A heel spur may or may not be present on an X-ray. Not all heel spurs hurt. It is the inflammation of the plantar fascia that causes the pain. Treatment is directed at reducing stress on the plantar fascia and decreasing inflammation at the attachment of the plantar fascia. It usually involves rest, heel cups, stretching, physical therapy modalities, strapping, orthotics, steroidal injections and non-steroidal, anti- inflammatory medications, stem cell injections, Platelet rich plasma, radiofrequency, homeopathic injections.
In a minority of cases when the above conservative measures fail to give relief, surgical intervention becomes necessary. The plantar fascia is released in part from its origin. When a large spur is present, reduction or removal could become necessary.
