According to the Australian Family Physician [1], approximately 3.6% of the population or over 900,000 Australians will experience heel pain. Of these people, 40% will have heel spurs.[2] However, according to the same study, 61% of people with heel spurs do not experience heel pain.
Having heel spurs is not a condition itself. Although spurs increase the likelihood of heel pain, many of these people live without symptoms. The most common risk factor for developing heel spurs is obesity.
Read on to understand what you should know about heel spurs; the risk factors, treatment options and expected recovery time.
What is a Heel Spur?
Heel spurs are extra bony growths that develop around the calcaneus (heel bone). The two most common locations are behind or underneath the heel. These spurs are closely related to heel pain developing from Achilles tendonitis and plantar fasciitis.
What are the symptoms of a heel spur?
The most common symptoms for heel spurs include sharp heel pain (especially first thing in the morning) that progresses to a dull ache during the day. People may also experience swelling in the heel, and some people will notice a visible protrusion under the heel.
Common symptoms of heel spurs
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Noticeable sharp, aching pain in the heel when you wake up in the morning
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Dull aching pain on the heel throughout the day
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Heel pain
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Swelling
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Redness and warmth sensation on the heel
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Small palpable protrusion of bone under the heel
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Tenderness and pain when touching the bottom of the heel
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Bare walking aggravates the pain.
What causes a heel spur?
Heel spurs are often the result of repeated stress on the muscles and ligaments of the foot, particularly the plantar fascia. The foot responds to this stress by laying down more bone to protect the foot, resulting in a heel spur.
Common causes of heel spurs
Sports that increase the risk of a heel spur
Sports that can damage the muscles and ligaments of the foot can increase the risk of a heel spur. Here is a list of the most common sports that can result in a heel spur:
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Long-distance running
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Basketball
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Soccer
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Tennis
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Baseball.
How is a heel spur diagnosed?
Heel spurs can be very painful and prevent you from doing the things you love to do. Your mobility may be limited, and it can also affect the quality of your life.
There are several options available when it comes to diagnosing your foot pain as a heel spur. One of the more common and most recommended by Australian GPs is an assessment from a physiotherapist.
Physiotherapists are rehabilitation experts that deal with musculoskeletal conditions like heel spurs. They are medically qualified to diagnose and provide quality treatment for your situation.
Your evaluation is similar to your visit to a GP. Your physiotherapist will ask you relevant questions regarding your injury and medical history. Take this time to discuss all your symptoms and your lifestyle.
After establishing a background of your condition, your physiotherapist will perform a physical test on your foot to check and rule out other factors that may be contributing to your pain.
Your physiotherapist will then create a specific treatment plan for you and will guide you through your recovery.
This will also include:
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Detailed treatment program
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Target goal for complete recovery
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List of home exercises to maximise your recovery
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Pain management strategies.
How is a heel spur treated?
Having heel spurs can be frustrating and occasional flare-ups are bound to happen if left untreated.
There are several options when it comes to treating heel spurs. One of the more common and the treatment option referred to by Australian GPs the most is physiotherapy.
Physiotherapists routinely assess and treat cases of heel spurs. They are in the best position to give quality care and treatment for your injury to help you regain normal function and improve your overall condition.
Your treatment will focus on decreasing inflammation, managing the pain, and creating a specialised treatment program to prevent flaring of your symptoms.
Depending on the severity of your heel spur, a physiotherapist may provide you with a combination of the following types of treatments:
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Manual therapy - Hands-on technique used to improve joint mobility of the foot.
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Shockwave therapy - Consists of high energy mechanical waves directed at your heel spur to help reduce inflammation.
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Heat therapy - Heating therapies can be used to loosen tense muscles and promote blood flow in your heel area.
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Taping techniques - Specialised taping techniques to add support to the foot arches and help reduce pain.
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Deep tissue massage - Hands-on techniques promote blood flow, decrease tension and improve pain in the foot.
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Stretching exercises - Gentle stretching exercises to help relieve muscle tension.
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Therapeutic exercises - Exercise techniques to correct impairments and increase muscle strength to support the foot arch.
A typical physiotherapy session with your local physiotherapist will last anywhere between 30-60 minutes. It is not uncommon for patients to feel the benefits in just one session.
Next step - Creating a treatment plan made for you
After your initial visit, your physiotherapist will create a detailed treatment program based on your lifestyle to maximise your recovery.
Self-care for heel spurs
There are always things you can do at home to complement any treatment you may be receiving.
Things to do:
Resting can help accelerate the healing of the soft tissues in your foot. Inflammation may worsen by walking for a long time or running.
Apply ice at least 15 minutes every 2-4 hours to the sore areas of your foot to decrease pain and manage the inflammation.
Apply gentle pressure on areas of your foot to relax the muscles and relieve tension on your foot.
Gently stretch the muscles and tendon of your foot and calf to relieve tension and maintain your normal range of motion.
Things to avoid:
- Avoid wearing high-heeled shoes
Wearing high heels causes extreme pressure on the soft tissues of your foot.
- Avoid high impact activities
Avoid high impact activities that would stress your foot, such as jumping and running.
- Avoid using shoes with a hard sole
As much as possible, use footwear with good arch support and soft cushions to limit the stress on your foot.
Do I need a specialist or surgery?
Diagnosis of a heel spur is usually confirmed by an X-ray, and in some cases, your doctor may perform an ultrasound scan.
Your GP may prescribe anti-inflammatory medications or corticosteroids to help manage the pain and control signs of inflammation.
Surgeons will, in some cases, actually remove the heel spur to minimise its contact with other soft tissue in the foot to prevent pain.
Your GP may coordinate with your physiotherapist to help you recover and regain your normal function.
What is the recovery time / prognosis for a heel spur?
Ultimately, recovery time is dependent on your proactiveness to seek professional treatment and the severity of your foot pain and heel spur.
In some cases, patients begin to feel the benefits of physiotherapy in just one session. Full pain relief can sometimes take a few weeks, up to several months, depending on severity.
Important factors in recovery include:
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Sticking to your rehabilitation program and regularly exercising
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Resuming your sports activity gradually
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Paying attention to pain, and resting as necessary.
Can a heel spur be prevented?
Guaranteeing prevention can be impossible; however, you can decrease the risk of pain from heel spurs through some of these techniques:
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Stretch and warm-up before an activity - Stretch your foot and calf muscles to relieve tension on the bottom of your foot before engaging in physical activity, particularly running.
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Wear proper footwear - Wear shoes with shock-absorbent soles and supportive heel counters to decrease the impact on your foot.
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Manage your weight - If you are overweight, it also helps to lose weight to prevent excessive stress on your feet.
Outlook and the main takeaways
Having heel spurs can be frustrating and can take a long time to heal. The bony overgrowth will always be there unless surgically removed. However, pain can be managed and resolved with conservative treatments.
Book a visit with a physiotherapist today to assess your heel spur and help you manage your pain, and improve your overall function.
Anatomy of a heel spur
Your heel is a part of your foot consisting of the calcaneus bone. It is a vital structure that provides attachment to the achilles tendon and the plantar fascia.
Your heel is repeatedly in contact with the ground when you walk, run or jump, adding load to the heel that can cause pain.
The excessive pulling action of the tendons around the calcaneus bone can lead to calcifications or bone overgrowth called bone spur. Over time bone spurs can irritate surrounding soft tissues resulting in inflammation and pain.
