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heel spur symptoms

Management of Heel Spurs

In the large majority of cases, pain in the heel can be simply treated by conservative and noninvasive podiatry heel spur treatments. Heel spurs, medically-known as calcaneal spurs, are calcium deposits that form at the end of the heel bone from repeated impact and stress over a period of time.

People with pain in the heel often do not experience plantar fascia pain directly related to the heel spur, but rather the pain is a result of other inflammatory and degenerative conditions such as plantar fasciitis, Achilles tendonitis, and osteoarthritis. The painful condition can also be caused by chronic inflammatory or degenerative nerve conditions like Tarsal Tunnel Syndrome and diabetic neuropathy.

How To Identify If You Have a Heel Spur

Heel spur symptoms include hook-like calcifications between the base and the foot arch, often without pain. What causes heel spurs is the repetitive stress on the foot’s muscles, tissues, and ligaments. The condition can vary in length — from very small to more than 1 cm — and grows in the direction where the tendon is being pulled from the heel.

Heel spurs are often found at the base of the foot due to plantar fasciitis or at the back of the heel attributed to Achilles tendonitis. Pain intensity ranges from a negligible dull ache to a constant sharp throb for those experiencing discomfort from heel spurs. 

Although anyone can get heel spurs, athletes, women, and the elderly are at greater risk of getting them:

  • Athletes can develop heel spurs as repeated stress on the feet can cause strain on the tissues of the heel. 
  • Women are more likely to get heel spurs from wearing high-heeled, tight, or narrow shoes. Restrictive shoewear can often shorten the length of the Achilles while putting pressure on the foot. 
  • Senior citizens sometimes have a reduced fat pad that cushions the impact of the heel on the ground, known as fat pad syndrome. As a result, repeated tension at the heel over time can increase the chance of heel spurs.

Genetic factors can sometimes cause heel spurs but more often form from stress on the tissues and tendons at the heel. Heel spur pain symptoms include an intense sharp pain that feels like a knife sticking into the heel. You can also experience discomfort at the bottom of the heel when you wake in the morning or during rest, but not during exercise. 

People with musculoskeletal issues often have difficulty standing, walking, running, and being upright on their feet for long periods. However, getting the best treatment for heel spurs starts with the proper diagnosis.

Common Misdiagnosis of Heel Spurs

What are the signs and symptoms of heel spurs? Only 5 percent of people with heel spurs will report discomfort in the heel area. Pain in the heel area is often an indication of another musculoskeletal dysfunction. Heel pain can result from:

  • Overuse injury
  • Anatomical structure of the feet (e.g. flat feet or high arches)
  • Muscle tightness in the calves and feet
  • Weight shifts, such as through rapid excess weight gain in pregnancy
  • An increase in the level of exercise
  • Spending too much time on your feet
  • Repeated impact of your heel against hard surfaces
  • Bone bruises from the impact of your feet against hard surfaces
  • Small stress fractures at the heel or foot
  • Abnormal gait, whether overpronation (turning too much inwards) or oversupination (the turning outwards) of your feet

Heel pain can also be caused by certain illnesses such as diabetes, inflammatory arthritic conditions, or Sever’s disease in children. 

More often than not, the source of heel pain is related to plantar fasciosis and Achilles tendinopathy. Plantar fasciitis is an inflammation of the tissue band (plantar fascia) that connects the heel to the toes through its archway. It is a common foot ailment often associated with heel spurs, as many who have plantar fasciitis also have heel spurs. However, plantar fasciitis is not caused by heel spurs, leading to its misdiagnosis as the cause of discomfort. 

Achilles tendonitis is an overuse injury in the tendon connecting the back of the leg to the heel, which commonly occurs in athletes and those with an increased level of activity that places an increased strain on the foot.
If you believe you have heel spurs, a consultation with one of our podiatrists can quickly assess whether the foot pain caused is from a heel spur or is attributed to another musculoskeletal injury or disease.

Musculoskeletal Dysfunctions Related to Heel Spurs

We see patients at The Foot Practice podiatry clinic daily with heel pain. Research on Google may indicate that the condition is a heel spur. However, the subtle differences that cause heel pain are best evaluated by a podiatrist or foot doctor.

Taking the necessary precautions to prevent heel spurs from forming in the first place is essential. These measures can include wearing supportive shoes, stretching muscles in the leg before movement and exercise, and using insoles to support overpronation and oversupination.

How to treat heel spurs starts with a proper diagnosis to develop the right treatment plan for your condition, primarily if the condition is caused by another dysfunction, such as:

  • Achilles tendonitis is an acute inflammatory condition often associated with the repetitive overuse of the largest tendon in the body that connects the calf muscles to the heel bone. 
  • Plantar fasciosis can occur with or without inflammation where the ligament at the bottom of the foot attaches to the heel bone, tightens and stretches, and causes pain due to repetitive strain.
  • Tarsal Tunnel Syndrome can lead to permanent and irreversible nerve damage as the posterior tibial nerve pinches at the tarsal tunnel, causing heel pain, numbness, and tingling. 
  • Diabetic neuropathy requires a multidisciplinary management approach as the chronic dysfunction causes slow and progressive nerve damage with unrelenting shooting, burning, numbness, and other associated pain.

These are only a few conditions that exhibit heel pain and can be mistaken for heel spurs.

Working with an experienced podiatrist in Singapore can make the difference between effectively managing your foot and ankle condition.

what causes heel spurs

Diagnosis, Treatment, Management and Prevention

Constant overuse strains the foot muscles, tendons, and ligaments. This is especially true for athletes with a lot of jumping or runners whose feet impact hard surfaces. In the large majority of cases, conservative heel spur treatment is effective in alleviating the symptoms of heel spurs. 

During your visit, our podiatrist will examine your lower limbs to see if you have limited flexibility in the ankle, the area of tenderness, flat or high-arched feet, and assess for other ailments, inflammation, or repetitive overuse from daily activities or acute trauma. You can have multiple concurrent conditions with a heel spur, including plantar fasciitis or Achilles bursitis.

If you experience heel pain, it is important to assess your symptoms as they can worsen over time, even leading to a debilitating disability. Our podiatrist will develop a plan to ensure proper diagnosis and management of your heel spur condition to restore the optimal function of your feet. 

How to Relieve Heel Spurs with Conservative Treatments

The large majority of heel pain can be treated by noninvasive, conservative therapies and rehabilitative exercises that focus on the affected tendon. 

heel spur treatment

Natural treatments for heel spur management to improve mobility and quality of life include:

  • Foot Mobilisation Therapy to strengthen and stretch the plantar fascia to ease the tension in the tissues.
  • Footwear Assessment guides properly fitting shoes with the right support that reduces the pressure on inflamed areas to protect the heel.
  • Shockwave Therapy uses acoustic soundwaves to noninvasively activate the body’s natural processes for tissue reconstruction to initiate the healing of heel spurs and related inflammation, thereby reducing the pain you feel.
  • Dry Needling treats the symptoms of heel spurs and tendon inflammation by releasing myofascial trigger points to relieve pain.
  • Orthotic Therapy may be prescribed to support the foot arch to redistribute pressure across the feet more evenly and activate proper foot muscles to alleviate biomechanical imbalances contributing to heel spur pain. In addition, getting an accurate 3D Gait Analysis is critical to getting the best results from custom-made insoles.

Other conservative protocols may include anti-inflammatory medications, ice packs, stretching exercises for the calf or to roll out the plantar fascia, night splints, heel spur taping to alleviate tension, and physical therapy can also aid in relieving pain from heel spurs. 

When to Know When Surgery Is Necessary

Surgery may be required in rare occasions as heel spur bone treatment. If we believe it is necessary, our podiatrists will refer you to a surgeon for the needle aspiration of the calcific deposits or an orthopaedic surgeon for a consultation to discuss heel bone spur surgical excision. 

Using modern techniques, recovery from removing the heel spur is relatively quick, and a podiatric aftercare rehabilitation plan effectively follows the results.

Heel Spur Management in Singapore

The Foot Practice Podiatry Clinic is at the forefront of innovation in managing foot and ankle musculoskeletal conditions in Singapore. With our pioneering technologies, including 3D infrared biomechanical gait analysis to shockwave therapies for lower limbs, our highly-specialised approach to managing heel spurs focuses on the least invasive therapies to restore optimal mobility and eradicate pain.  

If you believe you have heel spur symptoms, consulting one of our podiatrists can help assess your condition and provide the right plan for recovery for heel spurs or related dysfunction. As with other ailments, early diagnosis often leads to greater recovery and aftercare.

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The Foot Practice Podiatry Clinic
545 Orchard Rd
#16-13 Far East Shopping Centre
Singapore 238882

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