There are approximately 75 different causes of heel pain. At least 80% of all heel pain is due to heel spurs. A heel spur contains calcium, but cannot truly be called a calcium deposit. Bone spurs, whether they are on the heel or on any other bone of the body, are true bone — they are true enlargements of the bone and may be sharp and pointed, or round and knobby. Since bone spurs are true bone, they contain calcium just like regular bones, but are not pure calcium deposits.
When the Plantar Fascia is allowed to rest during sleep or long periods of inactivity, the fascia tightens and shortens. When you first stand up after resting, the fascia is forced to stretch very quickly causing micro-tears in the tissue. This is why the first steps in the morning are so exquisitely painful. Heel spurs are more likely to happen if you suffer from over-pronation (walking with a rolling gait) you stand or walk on rigid surfaces for long periods, you are above ideal weight or during pregnancy, you have stiff muscles in your calves.
An individual with the lower legs turning inward, a condition called genu valgus or “knock knees,” can have a tendency toward excessive pronation. This can lead to a fallen arch and problems with the plantar fascia and heel spurs. Women tend to suffer from this condition more than men. Heel spurs can also result from an abnormally high arch. Other factors leading to heel spurs include a sudden increase in daily activities, an increase in weight, or a thinner cushion on the bottom of the heel due to old age. A significant increase in training intensity or duration may cause inflammation of the plantar fascia. High-heeled shoes, improperly fitted shoes, and shoes that are too flexible in the middle of the arch or bend before the toe joints will cause problems with the plantar fascia and possibly lead to heel spurs.
Because the diagnosis of heel spurs can be confused with tarsal tunnel syndrome (as described earlier), most surgeons advocate performing a tarsal tunnel release (or at least a partial tarsal tunnel release) along with the plantar fascia release. This surgery is about 80percent successful in relieving pain in the small group of patients who do not improve with conservative treatments.
Non Surgical Treatment
Diathermy treatment uses an electrical current to produce heat that sedates the inflamed tissues. The ultrasound device sends sound waves into the heel and sets up a massaging action that stimulates blood circulation. Treatment with a whirlpool bath involves placing the foot directly into the jetting stream. Orthopedic molds and appliances, such as orthotics, are designed by foot specialists for use inside the shoe to eliminate irritation to the heel when the patient stands or walks. When those appliances are used, the spur (in effect) floats on air. At the same time, the body’s weight is transferred forward from the tender spot.
Surgery, which is a more radical treatment, can be a permanent correction to remove the spur itself. If your doctor believes that surgery is indicated, he will recommend an operation – but only after establishing that less drastic methods of treatment are not successful.