Calcaneal spur: Heel bone spur treatment without surgery

Most people do not realize they have a heel spur until they seek help for heel pain. Health care professionals recommend treatment of heel spurs without surgery to relieve symptoms. There is no cure for heel spurs.

A heel spur is a bony growth that protrudes from under the posterior heel bone on the inside of the foot. Calcaneal spurs occur when there is tension in the ligaments of the foot.

What is a calcaneal spur?

A calcaneal spur or bone spur is a bony growth that protrudes from the bottom of the heel, where the heel bone connects to the ligament that runs between the heel and the forefoot (the plantar fascia).

Calcaneal spurs affect approximately 15% of people.

This bony growth occurs as a natural defense mechanism of the body, in response to repeated traction and stress on the plantar fascia, which inserts into the calcaneus. Calcaneal spur formation is usually the result of chronic plantar fasciitis, i.e., persistent inflammation of the fibrous tissue that lines the sole of the foot.

The spur has a triangular or spear shape, and is specifically located on the underside of the heel.

It should be noted that, contrary to popular belief, the heel spur itself is not the cause of heel pain. Rather, it is a sign that there is an underlying problem, such as plantar fasciitis, that is causing stress and damage to the area.

The appearance of calcaneal spurs usually occurs after the age of 40, and is more common in people with flat feet or pes cavus.

Other risk factors include being overweight and practicing sports activities on hard surfaces with inadequate footwear.

Are calcaneal spurs the same as plantar fasciitis?

Heel spurs and plantar fasciitis are related conditions, but they are not the same.

Here is how the two conditions intersect:

Plantar fasciitis occurs when overuse stretches or tears the plantar fascia, the ligament that runs between the heel and the sole of the foot.

If you have plantar fasciitis, you will probably feel an intense throbbing pain in your heel that comes and goes throughout the day. The pain subsides when you walk for a while, but reappears when you sit down and get up to walk some more.

Calcaneal spurs can appear as a reaction to stress and inflammation caused by plantar fasciitis.

Over time, the body responds to stress by forming extra bone tissue. This extra tissue becomes a heel spur. Most people do not feel pain from a heel spur, but when they do, the pain is similar to plantar fasciitis.

What causes heel spurs?

Calcaneal spurs are the body’s response to stress and strain on the ligaments and tendons of the foot.

For example, when plantar fasciitis develops, the body responds to the stress by creating a heel spur.

You can also develop heel spurs if you repeatedly tear the covering over the heel bone or if you have a gait disorder.

A gait disorder is when a disease or condition affects your balance and coordination so that you cannot walk as you normally do.

Let’s take a look at the causes of heel spurs:

• Chronic plantar fasciitis: The main cause of heel spurs is plantar fasciitis that has become chronic, due to late diagnosis or inadequate treatment. Continued traction and overload on the plantar fascia causes microtears in the tendon, leading the body to generate calcium deposits to slow the progression of the damage and form the spur.
• Highly arched foot or flat foot: People with highly arched feet or flat feet are more likely to develop a heel spur, as these conditions can increase stress on the plantar fascia and lead to the formation of the spur.
• Overweight: Excess weight puts additional pressure on the feet, which can contribute to the development of a heel spur.
• Intense physical activity: Performing intense physical activities that involve overloading the feet, such as running long distances or walking without proper footwear, can be a cause of spur formation.
• Aging: Aging can weaken the tissues of the foot, which increases the likelihood of developing a heel spur.

How is a calcaneal spur diagnosed?

Health care professionals will usually examine your foot and ask you about the physical activity that may have caused your heel pain.

Ultimately, x-rays are one of the most common tests used by healthcare professionals to diagnose heel spurs.

Calcaneal spurs are diagnosed as follows:

• Clinical examination: The physician performs a physical examination of the foot and heel, palpating the area for the presence of a bony prominence. We pay attention to the signs and symptoms presented by the patient, such as heel pain.
• Medical history: we review the patient’s medical history, paying attention to family history, habits, type of footwear, previous trauma and sports activities.
• Imaging tests: Lateral heel x-ray is the definitive test to confirm the presence and size of the heel spur.
• Ultrasound can also be useful to make a dynamic study and see the behavior of the spur in relation to the plantar fascia.

How to remove a spur without surgery?

To treat a spur, measures such as rest, ice, anti-inflammatory medications and stretching exercises may be used. In some cases, orthopedic insoles or physical therapy are recommended.

If the pain persists and limits activity, the most effective treatment is infiltrations of platelet-rich plasma (PRP) and as a last resort surgery could be considered.

What is the treatment for heel spurs?

Calcaneal spurs are often treated in the same way as plantar fasciitis. This is because the heel pain blamed on heel spurs is actually caused by plantar fasciitis.

Treating the symptoms of plantar fasciitis can relieve the pain associated with heel spurs.

Physiotherapy treatments to remove heel spurs

Typical treatment includes:

• Rest your heel: If you run or jog, taking a break will relieve heel pain.
• Use cold compresses or ice: Applying ice to the sole of the foot can relieve heel pain.
• Take oral anti-inflammatory drugs.
• Use shoes or insoles that support the arches and protect the plantar fascia by cushioning the sole of the foot.

1.1 Rest and ice

The first line of treatment is usually rest from activities that cause pain, especially those involving heel impact.

Applying ice to the affected area for 20 minutes, several times a day, can also help reduce inflammation and pain.

1.2 Analgesics

Over-the-counter medications such as acetaminophen or ibuprofen can be effective in relieving the pain and inflammation associated with heel spurs.

1.3 Orthopedics

The use of orthopedic insoles or heel cushions can be beneficial to redistribute pressure on the heel and relieve pain.

Custom insoles can provide greater support and motion control, while heel cushions elevate the heel, reducing stress on the plantar fascia.

1.4 Physiotherapeutic treatment for heel spurs

Physical therapy exercises play an important role in the treatment of heel spurs. A physical therapist can design a patient-specific program, including stretching, muscle strengthening and proprioception exercises, with the goal of:

• Improve flexibility and mobility of the foot and ankle.
• Strengthen the muscles and tendons in the area.
• Reduce tension in the plantar fascia.
• Decrease pain and improve foot function.

1.5 Removing calcaneal spurs without surgery with injections

In some cases, the physician may recommend injections of medication to relieve pain and inflammation on a more localized basis.

The most common options include:

• Steroid injections: These potent anti-inflammatory drugs can provide temporary relief of pain and inflammation.
• Injections of local anesthetics: These are injected into the affected area to temporarily block pain signals traveling to the brain.

How to remove heel spurs without surgery: Treatment with PRP infiltrations

Platelet-rich plasma (PRP) infiltrations have emerged as a promising alternative in the treatment of heel spurs, a painful condition characterized by the formation of a bony growth on the heel.

PRP, obtained from the patient’s own blood, contains a high concentration of growth factors that can stimulate tissue repair and reduce inflammation.

How does PRP infiltration treatment for heel spurs work?

The process consists of drawing a small amount of blood from the patient, centrifuging it to separate the cellular components (platelets) from the plasma, and then injecting the concentrated PRP into the affected area of the heel.

The growth factors present in PRP:

• Promote regeneration of the plantar fascia: The plantar fascia is the tissue that lines the heel and is inflamed in the presence of a heel spur. PRP can stimulate the repair of this tissue, reducing pain and inflammation.
• Decrease inflammation: The growth factors in PRP have anti-inflammatory properties, which can help relieve the pain and swelling associated with heel spurs.
• Improve vascularization: PRP can improve blood flow to the affected area, which promotes the arrival of nutrients and oxygen for tissue repair.

In which cases are PRP infiltrations recommended?

PRP infiltrations for heel spurs may be a viable option in the following cases:

• Patients with moderate to severe pain: When conservative treatments such as rest, ice, analgesics and physical therapy have failed to significantly relieve pain.
• New onset calcaneal spur: PRP infiltrations may be most effective in the early stages of the condition.
• Patients who wish to avoid surgery: PRP infiltrations may offer an alternative to surgery for those seeking to avoid invasive procedures.

Opinions on treatment of heel spurs with PRP injections

Heel spur treatment with surgery

Ultrasonic tenotomy

In 80% of cases, the pain caused by plantar fasciitis resolves within the first six months with conservative treatment.

However, the remaining 20% of patients experience persistent and recurrent symptoms, leading to chronic pain.

In these cases, it is likely that the normal tendon tissue has deteriorated and been replaced by damaged degenerative tissue.

Definitive treatment for these chronic cases of plantar fasciitis involves removal of the damaged tissue through ultrasonic tenotomy or fasciotomy surgery, thus facilitating complete recovery of the body.

Both tenotomy and fasciotomy can be successfully performed through a conventional open surgical approach or through an ultrasound-assisted surgical method with Tenex.

Tenex offers physicians the ability to perform ultrasound-guided tenotomies in a minimally invasive manner, which minimizes pain and shortens recovery time.

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Reference Center in Regenerative Therapies

Most common surgical techniques for calcaneal spurs

Surgery is usually considered as a last resort when conservative treatments have failed to provide significant pain relief.

• Heel spur removal: The surgeon makes an incision in the heel and removes the heel spur.
• Plantar fascia release: In this procedure, tension in the plantar fascia, which may be contributing to pain, is released.
• Arthroscopic surgery: A miniature camera and special tools are used to perform surgery through small incisions, minimizing trauma and recovery.

Prevention of heel spurs

There are several factors that increase the risk of developing heel spurs.

Some factors are things you can change immediately or change over time. Others you cannot change.

Changes you can make right now

• If you jog or run, choose soft surfaces such as grass and paths rather than hard surfaces such as sidewalks and sidewalk.
• Wear shoes that fit and support your arches.
• Wear slippers or shoes if walking on wood or tile floors.
• Adjust your gait so that your heels suffer less pressure.

Changes you can make over time

– Lose weight to put less pressure on the foot.
– Change your daily routine so you are not on your feet so much.

What you cannot change

With age, the plantar fascia becomes less flexible, more prone to damage and more prone to developing plantar fasciitis.

You gradually lose the natural fat pads on the soles of your feet.

Frequently asked questions about heel spurs

Does the calcaneal spur have a definitive cure?

There is no “definitive cure” for heel spurs that works the same for all patients, as treatment can vary considerably depending on each person’s individual circumstances.

However, there are multiple approaches to manage and significantly reduce the symptoms associated with heel spurs.

Different conservative treatments , PRP infiltrations and surgery with either ultrasonic tenotomy or fasciotomy surgery are effective in controlling symptoms and improving the condition in the long term.

The key is proper diagnosis and treatment under medical supervision.

Is it good to walk with a spur?

Walking with a heel spur can be uncomfortable and painful for some people, especially if the spur is causing irritation to surrounding tissues, such as the plantar fascia.

Although there is no absolute consensus, it is recommended to avoid activities that aggravate symptoms, such as walking long distances, standing for prolonged periods of time or wearing inappropriate footwear that puts additional pressure on the heel.

Keep in mind that each case is unique and pain tolerance varies from person to person. If walking pain is significant or limits mobility, it is advisable to consult a podiatric or orthopedic specialist for an accurate diagnosis and appropriate treatment plan.

Do heel spurs disappear without surgery?

Once formed, calcaneal spurs are permanent.

Surgery is the only way to remove a heel spur. Since heel spurs usually do not hurt, treating the condition that caused them should help relieve heel pain.

The heel spur can be removed as part of plantar fasciitis surgery, but healthcare professionals rarely operate to remove heel spurs.

Make an appointment to cure your ailment without surgery at Regenerat clínica

Specialists in regenerative medicine

Regenerat clinic has a team of specialists led by Dr. Miguel Alfonso Porcar, highly qualified in regenerative medicine.

Dr. Miguel Alfonso Porcar and his team have extensive experience in the treatment of musculoskeletal pathologies in the hip, shoulder or elbow. In many cases it will be possible to recover without surgery by applying the most advanced techniques of cell therapy and platelet growth factors.

We will provide you with a personalized treatment, always focused on improving your quality of life and reducing pain and inflammation in your affected joint.