What is a heel spur? Symptoms and treatment

Heel spurs can be the cause of significant heel pain. Believe it or not, you probably have bone spurs without knowing it, because most bone spurs themselves cause no symptoms.

But if a spur on your heel bone happens to rub on soft tissue like the plantar fascia, causing plantar fasciitis, or worse yet on a nerve, the tissue breaks down, causing swelling, pain, and tearing. Bone spurs in the foot can also cause corns and calluses as tissue builds up around the spur.

Spur shaped growth at back of heel is a heel spur

When your heel bone is exposed to repeated activities that put stress on your feet, downward pressure from being overweight, or stress from wearing poorly fitting shoes, calcium deposits form on the bottom of the bone. These deposits build on each other, eventually causing a spur-shaped deformity called a calcaneal spur (calcaneal is the medical term for your heel bone).  Those who are obese or have flat feet, and women who frequently wear high heels are most susceptible to heel spurs.

Although many people with plantar fasciitis have heel spurs, spurs themselves are not the cause of plantar fasciitis pain. In fact, one out of 10 people have heel spurs, but only 5 percent of these have foot pain. Because the spur is not the cause of plantar fasciitis, the pain can be treated without surgically removing the spur.

Read: FAST procedure relieves plantar fasciitis

What are the symptoms of heel spurs?

• Pain on the bottom of the foot near the heel
• Pain during the first few steps upon getting out of bed in the morning, or after a long period of rest. The pain subsides after a few minutes of walking
• Increased pain after, but not during exercise or activity

How are heel spurs treated? 

Heel spurs do not require treatment unless they are causing pain or damaging other tissues. When indicated, treatment may be directed at the causes, the symptoms, or the spurs themselves. More than 90% of patients with plantar fasciitis caused by a heel spur will improve within 10 months of starting simple, non-surgical treatments.

Rest: Decrease or stop the activities that make the pain worse, such as running on hard surfaces

Ice: 20 minutes 3 to 4 times a day

Weight Control: If the heel spur is due to obesity, losing weight will take some of the pressure off the foot

Over the counter medication: Non-steroidal anti inflammatory medicines such as ibuprofen (advil) or naproxen (aleve)

Better shoes and orthotics: Shoes with thick soles and extra cushioning can reduce pain.  Pre-made or custom orthotics (shoe inserts) are helpful as well as soft silicone heel pads to elevate and cushion your heel.

Night splints. Most people sleep with their feet pointed down, which relaxes the plantar fascia. This is one of the reasons for morning heel pain. A night splint stretches the plantar fascia while you sleep and does not have to be used after the pain subsides

Physical therapy. We may suggest physical therapy to stretch your calf muscles, heel cord, and plantar fascia

Extracorporeal shockwave therapy (ESWT): High-energy shockwaves stimulate the healing process in damaged plantar fascia tissue. ESWT is noninvasive—it does not require a surgical incision.

If the bone spur continues to cause pain, we may suggest a steroid injection at the painful area to reduce pain and inflammation of the soft tissues next to the bone spur. If pain continues, surgical intervention may be recommended.

Remember, no pain is normal. If you have persistent heel pain, your body is telling you that something’s wrong.

Should I see a Podiatrist or an Orthopedist?

Well, that explains the excruciating pain and the baseball-size swelling in your ankle after you jumped off the trampoline…

Your family physician just pointed to a dark line on your x-ray which shows a fracture of your ankle. She suggests you see a specialist, but will she recommend an Orthopedist or a Podiatrist? Which should you choose?

The difference between an orthopedist and a podiatrist

An Orthopedist is devoted to the diagnosis and treatment of your entire body’s musculoskeletal system: the interworkings of the bones, muscles, tendons, ligaments and joints. Some orthopedists specialize in treating the foot and ankle, while others focus on hands, shoulders, spine, hips, etc. If you choose an orthopedist, make sure that they specialize in foot and ankle.

A Podiatrist is a Doctor of Podiatric Medicine, who is trained intensively in the care of the feet, ankles, and lower legs. Podiatrists are also trained in the biomechanics of the foot and ankle and are trained to fit orthotics, custom shoes, braces, and similar devices. Additionally, some Podiatrists are Podiatric Surgeons, who can perform foot and ankle surgery in a hospital setting when necessary.

A Doctor of Podiatric Medicine (DPM) is the foremost medical and surgical specialist of the foot and ankle and is the only medical specialist educated, trained, licensed, and certified for exclusive treatment of the foot and ankle.

Podiatric Surgeons complete a 3 year hospital based residency which includes training in all aspects of foot and ankle surgery. There are some that choose to complete a 1 year fellowship to further focus on areas such as diabetic limb salvage or sports injuries of the foot and ankle. But not all Podiatrists choose to perform all types of foot and ankle surgery just as not all Orthopedic Surgeons choose to perform back surgery vs knee surgery.

Just as with any physician, you should always make your choice based upon their reputation.

The human foot and ankle is one of the most intricate and complex anatomical structures in your body, marrying the precision of a Swiss watch with the structural strength of a cantilever bridge. Your foot is a complex apparatus of 26 bones (one-quarter of all the bones in the human body), 33 joints and more than 100 ligaments and tendons, all linked and served by a vast network of nerves, muscles, blood vessels, soft tissue and skin. All of these parts work in unison to provide the support, strength, flexibility and resiliency needed for actions most of us take for granted, such as balance, walking, running and jumping.

Podiatric surgeons provide comprehensive medical and surgical care for a wide variety of common and complex foot and ankle conditions that affect children, adults and the elderly. They are uniquely qualified to detect the early stages of diseases that show warning signs in the toes, foot, ankle or lower leg, such as diabetes, arthritis and cardiovascular disease. Early diagnosis and treatment by podiatric physicians may save patients from amputation, restore mobility or prevent other serious health problems.

New FAST Technique Relieves Heel Pain and Arch Pain

PA Foot and Ankle Associates in Allentown stands on the cutting edge of successful, reliable medical technology and sports medicine. We’re proud to announce that we now offer the FAST Technique for patients suffering heel pain and arch pain associated with chronic tendinitis or tendinosis.

In the past, if you had chronic pain in your Achilles tendon (at your heel) or plantar fascia (arch of your foot), treatment options would include ice, rest, elevation and over the counter pain meds. If that failed to work, your podiatrist may have used a shot of the steroid hydrocortisone to relieve your pain and physical therapy. If the pain returned, open surgery to remove the damaged tendon may have been recommended.

There’s now an alternative to the open surgery option: The FAST Technique, a minimally invasive alternative to open foot surgery for these conditions. FAST is an out patient procedure performed with only local pain medicine, no anesthesia, and you return home that same day.

FAST uses ultrasound imaging, similar to the ultrasound used to visualize babies in the womb, to guide the physician during the procedure. Once the damaged tendon is identified, the podiatric surgeon delivers high frequency energy through a needle only the size of a toothpick, which breaks down the damaged tissue and removes it. The entire procedure takes less than 15 minutes.

This is a really exciting new procedure, because 95% of patients experience pain relief within one week. Visit the FAST Technique page on the PA Foot and Ankle  Associates website to learn more about eliminating heel pain and arch pain caused by chronic tendinitis or tendinosis.

Do you think East Penn Foot and Ankle Associates could have prevented Ryan Howard from rupturing his Achillles Tendon?

Ryan Howard Injured his ankle (Photo credit: Wikipedia)

Ryan Howard of the Phillies had been having problems with his ankle for weeks preceding his season ending injury. He had been trying to continue to play, but his ankle pain was making it difficult for him to remain on the field. Without time to rest before the playoffs, Howard opted for an injection of cortisone in the area of the Achilles tendon. The injection was given 2 weeks before his tendon ruptured.

Injecting a steroid such as cortisone around the Achilles tendon is very controversial. Injections into the tendon or around the tendon are known to increase the likelihood of tendon rupture. Usually, if an injection is considered, a lengthy period of rest and avoid major physical activity for a period of time to avoid tendon ruptures will follow the injection.

At EPFAA we would have suggested EPAT (Extracorporeal Pulse Activation Technology) for his injury to alleviate his Achilles tendon pain. EPAT is a new technology introduced to the Lehigh Valley by Dr. Adam Teichman. EPAT, is a painless treatment used to treat chronic pain such as Achilles tendonitis. The mode of action during Pulse Therapy is to stimulate the chemical process providing improved blood circulation in the pain regions to promote natural healing without restriction of any activity.

Benefits of EPAT:
• Patients are immediately fully weight-bearing without restriction of activity.
• Over 80% successful outcomes [Published Data–Long-term pain relief (Results retained)].
• Non-invasive so bio-mechanics are not affected–future treatment options are not limited.
• Fast, safe and effective.

To learn more, visit our website. If you are interested in the EPAT program, schedule an appointment.  Here at East Penn Foot & Ankle Associates, we are committed to your health.

Related articles

• Eagles All-Pro Offensive Tackle Jason Peters Ruptures Achilles (philadelphia.cbslocal.com)
• Everything Achilles Tendon (coachdeanhebert.wordpress.com)
• Ryan Howard Loses The Boot (philadelphia.cbslocal.com)

New Plantar Fasciitis Treatment Could Relieve Foot Condition

Image via Wikipedia

Are you struggling with pain and inflammation caused by plantar fasciitis?  Have you tried to relieve the pain through cortisone treatments, but have not had much success?  Well you may be interested in a new treatment, which has been effective in treating extreme plantar fasciitis foot pain.  It is called “platelet-rich plasma” therapy and new medical studies have found this type of treatment has helped those individuals who suffer from plantar fasciitis, and have had little success with nonsurgical treatment.

Plantar fasciitis is a common foot condition, where the tissue that connects the heel bone to your toes and supports the arch of your foot, called the plantar fascia, becomes strained and creates extreme heel pain while standing or walking. Common treatments for the condition include rest, supportive shoes and orthotic inserts, or cortisone shots to help with mobility.

However, this newly found treatment takes on a different approach to healing, one that contradicts the common cortisone treatment.  Instead of using cortisone, a plasma and platelet enriched fluid is injected into the foot. These two substances help connect tissue growth and vascular healing, as well as promote inflammation. Subjects who received this therapy showed improvement with foot functioning just after four weeks, which remained consistent up to a year afterward.

This new treatment has some podiatrists hopeful to become widespread as a successful plantar fasciitis treatment alternative.   Mostly because of the lack of success common treatments used today have on people who suffer from the condition. Cortisone shots have become a debated topic as far as if the treatment is beneficial enough for the patient. The reason for questioning is because cortisone is degenerative. Although patients experience pain relief following injections, cortisone doesn’t help heal the strained tissue, and foot pain can return again in only a matter of weeks after treatment.

This new treatment study has yet to be fully medically acquired and approved, but researchers and doctors are hopeful that this injection can better benefit patients in the future by relieving pain that is caused by plantar fasciitis.
So what do you think?  Have you had success with cortisone shots in treating plantar fasciitis?  Would you be open to trying a new treatment?  Feel free to comment below, we would love to hear what you think.  If you have any questions, please contact PA Foot & Ankle Associates today!

What is ESWT?

You Simply Do Not Have to Suffer From Heel Pain Any Longer

I want to let you know about a state-of-the-art, painless procedure that we offer at East Penn Foot and Ankle Associates to treat heel pain. It is called Extracorporeal Shock Wave Therapy, or ESWT. With the new treatments we offer, like ESWT, there is simply no reason for you to suffer from unnecessary heel pain any longer.

 There Are New Procedures That Can Help!

Extracorporeal Shock Wave Therapy, or ESWT, is a state-of-the-art option for people who suffer from chronic heel pain. It is a non-invasive procedure using high energy sound waves that takes no longer than 20 minutes and shows results very quickly.

The basic idea behind ESWT is very simple. The foot is placed on a machine which sends about 3,600 sound shock waves to the area where the plantar fascia (the connective tissue) is inflamed and hurting. These waves are able to break down and get rid of bad tissue and allow healthy tissue to take its place. It helps bring new blood vessels to the area, and then breaks up the scar tissue which essentially creates a healing process.

Heel Pain Doesn’t Have to Slow You Down.

Shock wave therapy does not hinder your everyday activities. You will still be able to go on like before without the use of crutches or a cast. There is no down time required; the only thing that is required, in fact, is stretching exercises which we will give you to do.

Over the span of about 2 to 3 months your heel will continue to heal. Most patients will see results almost immediately and by the end of the 3 months will have no pain left.

Please make your very next step on your 75,000 mile journey a visit to our office so that we can discuss your heel pain symptoms and find the right treatment for you.

When you are suffering from heel pain you are suffering needlessly. If you or someone you love is experiencing any pain or discomfort in your heels, please give us a call at 610-432-9593 and make an appointment to come in to see us. We will take the time to listen to you, understand your concerns, and then offer the best treatment options.

Dedicated to your health,

Adam Teichman, DPM

P.S. You can call our office at 610-432-9593 to schedule an appointment. We are located at 2895 Hamilton Blvd., Suite 101 in Allentown. You can also visit our website at www.EastPennFoot.com.

P.P.S. If you know someone else in our area who would benefit from their own copy of my free book Heel Pain 101, please have them call 888-482-9604 or visit our website to request their own personal copy.

Meet our Staff

Here is the staff from the PA Foot & Ankle Associates Allentown, PA location. We appreciate all of their dedicated work!

When should you visit a podiatrist?

Going to the podiatrist is not just for elderly people. Like other doctors, it’s a good idea to visit early to establish a baseline so you can compare changes in your feet from year to year.

At PA Foot and Ankle Associates we are not just here for you when you have a problem with your foot or ankle.  Having a starting point is a great way to mark the changes in your feet. Three-quarters of Americans will experience some sort of foot or ankle problem in their lifetimes, so starting examinations early is the key to prevention.

Contact PA Foot And Ankle Associates to make your appointment for a complete foot and ankle wellness exam today.