Heel spur

VOL 118 / NO 1 / JULY 2005 / POSTGRADUATE MEDICINE

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The calcaneus, or heel bone, the largest of the 26 bones in the foot, absorbs much of the weight of the body. Shock and pressure from walking, running, or jogging on hard surfaces; wearing shoes that don't fit; and being overweight put additional stress on the heel. In some people, the extra wear and tear can cause a heel spur.

What is a heel spur?
A heel spur is a bony growth that forms on the bottom or back of the heel bone. It can be painful but often causes no symptoms.

What causes a heel spur?
Heel spurs are often related to a condition called plantar fasciitis (plan-ter fa-she-eye-tes), an inflammation of the thick band of connective tissue (fascia) that runs from the heel to the toes on the bottom of the foot. Plantar fasciitis is caused by strain that leads to stretching and tearing of the fascia. As the fascia breaks away from the heel bone, calcium is deposited on the heel and the spur forms.

How is a heel spur treated?
The goals of treatment are to reduce the inflammation and avoid further injury. You may see either your family physician or a foot specialist called a podiatrist. Once the heel spur is confirmed with an x-ray, your doctor may recommend a heel insert (a cup, cradle, or other device to protect the foot) in your shoes, taping or strapping the foot, or an oral or injectable medication to reduce the inflammation. You may be referred to a physical therapist. Only rarely is surgery needed.

Some people find that resting the foot, applying ice to the painful area, and taking acetaminophen (for example, Tylenol) or ibuprofen (for example, Advil) help relieve the pain. Call your doctor if the pain isn't getting better after 2 to 3 weeks or if you notice heel redness or swelling.

How can I prevent heel spurs?
Heel spurs may be prevented by minimizing wear and tear.

• Wear well-fitting shoes with arch supports and shock-absorbing soles.
• Warm up with gentle calf and foot stretches before exercising.
• Avoid exercises that involve jumping or repeated stress (for example, aerobics or jogging) on hard surfaces, such as pavement or concrete.
• Avoid prolonged walking downhill or on rocky or uneven surfaces.
• Achieve or maintain a healthy body weight.

For more information American Academy of Podiatric Sports Medicine 888-854-3338 http://www.aapsm.org American Podiatric Medical Association 9312 Old Georgetown Rd Bethesda, MD 20814 800-366-8227 http://www.apma.org/s_apma/doc.asp?

This information is not a substitute for medical treatment.

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