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Heel spur—common cause of heel pain

July 1, 1993

Heel spur is a common form of pain in the heel. The most common symptom is pain in the heel when a person first gets up in the morning. A person can also get this problem after sitting down for a period of time. This can occur, for example, when a person has been sitting in a car for a long time, or even just sitting down for lunch. Sometimes the pain goes away after the person has been moving around for a while. Sometimes the pain does not go away, and is a constant, nagging problem. For some people, the pain may become so severe, it becomes almost impossible to walk.

The cause of this problem is usually due to excessive stress and strain on a soft tissue called the plantar fascia. This tissue, which helps support the arch of the foot, extends from the bottom of the heel to about the ball of the foot. A change in the amount of exercise a person does, or a gain in weight can cause this excessive strain. This strain can cause the plantar fascia to tear away from the heel bone. A deposit of calcium will occur, and on an X-ray, the calcium deposit will look like a spur on the bottom of the heel.

When the problem has not gone away after a few weeks, treatment by a professional may be necessary. Many treatments are available and include: oral medications, physical therapy, arch supports, cortisone injections, night splints, some forms of stretching, and in sever cases, surgery. Conservative non-surgical care is successful in resolving the problem in 90 percent of cases.

What can a person do to try to prevent this problem? Make sure the shoes you wear are in good shape, not excessively worn out, and have good arch support. If you are planning to start exercising, or are planning to increase your exercise routine, make sure you do proper warm-ups and stretching prior to engaging in your activity. After you exercise, a cool-down period can help prevent this problem. If you walk on a treadmill, make sure it is not in a constant “uphill” mode as this will cause too much stretch on the plantar fascia. If you have had an increase in body weight, a weight loss program can help. However, if you have severe enough pain to stop you from a weight loss program, you may need to get the heel problem fixed first.

It is important to remember that heel spur is a common cause of pain. However, there are other conditions that can cause heel pain. These include tarsal tunnel syndrome, some arthritic conditions that affect the heel, muscle strain, bursitis, and even a pinched nerve within the heel. If your problem does not go away soon, it may be time to seek professional help.

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