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Heel spur not the cause of heel pain
In day-to-day practice, heel spur is claimed to be the culprit for heel pain. The fact is the heel pain is usually the result of plantar fascitis.
The myth, however, persists as it is deeply engraved in the minds of public and doctors too that heel spur which appears on X-ray is usually considered the reason for heel pain.
There is a deposition of calcium at the site where plantar fascia is attached to the heel with progression of age and this is what comprises the spur.
The body responds to inflammation by scar tissue formation and bone deposition at insertion site.
This effectively shortens the fascia and forms heel spur. The heel is attached to the foot by a strong ligament i.e. plantar fascia.
In individuals afflicted with it, there is partial tearing and inflammation at its attachment at heel causing pain.
Most people have heel spurs but do not experience pain. It is actually easier to pronounce heel spur than plantar fascitis as the reason for pain. Normally a patient describes the pain due to bone growth.
Pain and spur occurs due to stress exerted on the plantar fascia leading to irritation, inflammation and heel pain.
The pain is most severe and could be extremely excruciating when getting out of bed or after prolonged rest.
Causes:
- Increased/ change/ start in activity
- Shoes without arch support
- Weak calf muscle
- Flat/high arched feet
- Over weight/ obesity
- Fat pad atrophy
- Tight Achilles tendon Plantar fascia gets inflamed when under constant stress e.g. Individuals on feet/ hard surface for prolonged periods of time. Wearing archless shoes or cushion less toe portion
Treatment:
- Rest is crucial. Advisable not to walk through pain
- Using a silicon heel
- Ultrasound massage with stretching.
- Using sports shoes (with more cushion/ flexible and raised heel).
- Deep friction massage on golf ball
- Injection steroid decreases pain and inflammation. Exercises go a long way in alleviating pain when done 4-5 times a day
- Calf stretch with towel/stretch band and against wall
- Plantar fascia stretch against wall
- Toe curls (towel) –Thrice a day
- Inclined board stretching
- Hamstring stretch
- Achilles stretch: Lifting feet 6’-10” ahead, shifting weight on left foot with knee bend and moving knee to left/right - 20 reps.
- Stationary bicycle/ swimming/ deep water running heel pain is, as the myth goes not due to heel spur but due to plantar fascitis. It is extremely critical to reconsider when an individual is advised surgery for “heel spur”.
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