Although many people with plantar fasciitis have heel spurs, spurs are not the cause of plantar fasciitis pain. One out of 10 people has heel spurs, but only 1 out of 20 people (5%) with heel spurs
has foot pain. Because the spur is not the cause of plantar fasciitis, the pain can be treated without removing the spur.
When a patient has plantar fasciitis, the plantar fascia becomes inflamed and degenerative (worn out)--these abnormalities can make normal activities quite painful. Symptoms typically worsen early in
the morning after sleep. At that time, the plantar fascia is tight so even simple movements stretch the contracted plantar fascia. As you begin to loosen the plantar fascia, the pain usually
subsides, but often returns with prolonged standing or walking.
Most heel spurs cause no symptoms and may go undetected for years. If they cause no pain or discomfort, they require no treatment. Occasionally, a bone spur will break off from the larger bone,
becoming a ?loose body?, floating in a joint or embedding itself in the lining of the joint. This can cause pain and intermittent locking of the joint. In the case of heel spurs, sharp pain and
discomfort is felt on the bottom of the foot or heel.
A Heel Spur diagnosis is made when an X-ray shows a hook of bone protruding from the bottom of the foot at the point where the plantar fascia is attached to the heel bone. The plantar fascia is the
thick, connective tissue that runs from the calcaneus (heel bone) to the ball of the foot. This strong and tight tissue helps maintain the arch of the foot. It is also one of the major transmitters
of weight across the foot as you walk or run. In other words, tremendous stress is placed on the plantar fascia.
Non Surgical Treatment
The heel pain associated with heel spurs and plantar fasciitis may not respond well to rest. If you walk after a night's sleep, the pain may feel worse as the plantar fascia suddenly elongates, which
stretches and pulls on the heel. The pain often decreases the more you walk. But you may feel a recurrence of pain after either prolonged rest or extensive walking. If you have heel pain that
persists for more than one month, consult a health care provider. He or she may recommend conservative treatments such as stretching exercises, shoe recommendations, taping or strapping to rest
stressed muscles and tendons, shoe inserts or orthotic devices, physical therapy. Heel pain may respond to treatment with over-the-counter medications such as acetaminophen (Tylenol), ibuprofen
(Advil), or naproxen (Aleve). In many cases, a functional orthotic device can correct the causes of heel and arch pain such as biomechanical imbalances. In some cases, injection with a corticosteroid
may be done to relieve inflammation in the area.
When chronic heel pain fails to respond to conservative treatment, surgical treatment may be necessary. Heel surgery can provide relief of pain and restore mobility. The type of procedure used is
based on examination and usually consists of releasing the excessive tightness of the plantar fascia, called a plantar fascia release. Depending on the presence of excess bony build up, the procedure
may or may not include removal of heel spurs. Similar to other surgical interventions, there are various modifications and surgical enhancements regarding surgery of the heel.
To prevent this condition, wearing properly fitted shoes with good arch support is very important. If a person is overweight, weight loss can help diminish stress on the feet and help prevent foot
problems. For those who exercise frequently and intensely, proper stretching is always necessary, especially when there is an increase in activities or a change in running technique. It is not
recommended to attempt to work through the pain, as this can change a mild case of heel spurs and plantar fascitis into a long-lasting and painful episode of the condition.