Why heel spurs are not always the cause of heel pain
For people that suffer from heel pain, heel spurs have become a catch-all presumed cause and are therefore often cited as being the culprit. But this is not always the case. A heel spur can develop without causing any pain, and heel pain has a number of other possible causes.
Formed by a calcium deposit developing into a bony protrusion on the underside of the heel bone, a heel spur is often painless but can cause heel pain. It’s often associated with plantar fasciitis, which is the inflammation of the fibrous band of connective tissue that runs along the bottom of the foot, connecting the heel bone to the ball of the foot.
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The strain on the foot muscles and ligaments, stretching of the plantar fascia and repetitive tearing of the membrane that covers the heel bone can cause the development of a heel spur. The condition is especially common amongst athletes engaging in activities that include frequent running and jumping. Hence the cause of pain is not the heel spur but injury to the soft tissue surrounding it.
A heel spur can only be positively identified by means of an x-ray, where it can them be seen to extend forward by as much as half an inch. Without x-ray evidence, the condition may be referred to as ‘heel spur syndrome’.
The pain is described by patients as a stabbing pain that is often worse first thing in the morning or after a long period of sitting down – this is as a result of a sudden elongation of the fascia band, which stretches and pulls on the heel upon standing up.
Risk factors contributing to the development of heel spurs :
- Walking gait abnormalities that put excessive strain on the heel bone, ligaments and nerves near the heel.
- Frequent running on hard surfaces.
- Ill-fitting or worn-out shoes, especially if they lack adequate arch support.
- Being overweight.
- Ageing, which decreases the flexibility of the plantar fascia and thins the protective fat pad over the heel.
- Spending much of the day on ones feet.
- Frequent short bursts of physical activity.
- Flat feet or high arches.
What are the other possible causes of chronic or intermittent heel pain?
Principal Sports Podiatrist and Director for Footwork Podiatry, Mark Lin, has this to say, “A heel spur does not always cause pain. Research has shown that 15% of the general population have heel spurs that don’t cause any pain. More often, it’s the related factors contributing to the formation of the heel spur that are the cause of the pain. Mechanical stress, repetitive pressure, inflammation or tears in the plantar fascia are the most common causes of heel pain.
Therefore, instead of treating the heel spur and trying to get rid of it, we instead focus on a rehabilitative and corrective treatment approach to address the underlying cause of the heel pain.”
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Lin is an authoritative expert on the subject, and he describes a number of other condition could be the real reason behind nagging heel pain:
Achilles tendinitis – inflammation of the Achilles tendon is common among people to partake in a lot of running and/or walking lot and have tight tendons. When the tendon is strained over time, the fibres stretch or tear along the length or where it attaches to the heel bone. This leads to inflammation, pain and the possible growth of a bone spur. The condition is aggravated by chronic irritation as a result of an active lifestyle, and activities that put excessive strain on an already tight tendon.
Heel bursitis (subcalcaneal bursitis) – an inflammation of the bursa (a fibrous, fluid-filled sac) under the heel bone. The pain is typically more pronounced in the centre of the heel and worsens during the day.
Tarsal tunnel syndrome – presenting as a burning or tingling sensation underneath the heel and within the arch of the foot, this syndrome may also cause occasional loss of sensation on the bottom of the foot. It’s caused by compression of the tibial nerve as it passes the inside of the ankle.
Severs disease (calcaneal apophysitis) – this usually affects growing active children between the ages of 8 and 12, especially during a growth spurt and results from inflammation of the Achilles tendon where it attaches to the heel bone.
If you’re struggling with heel pain, Footwork Podiatry is always on hand to assist and answer any questions you may have. They’ll point you in the right direction to put your heel pain behind you, so you can get back to doing what you love. They offer a range of advanced manual therapies and unique hands-on treatment solutions to common problems of the foot and lower limb.
Footwork Podiatry takes top-quality care seriously and is your go-to source for any running related injuries. Find them in two convenient locations, in Roseville on Sydney’s North Shore and Sydney CBD. For further information, visit the Sports and Podiatrist Clinic to book online, or call Mark Lin or Wei Lee and their friendly team on +61 2 9416 7889.
The information contained in this guide is provided in good faith and is not intended to be nor is it to be used as a substitute for any sort of professional, medical or podiatric advice. An accurate diagnosis can only be made following personal consultation with a podiatrist. Any users should always seek the advice of their podiatrist, or other qualified healthcare providers before commencing any treatment.
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