The heel spur
definition
A heel spur is a bony protrusion or extension. A distinction can be made between an upper and a lower heel spur:
The upper or dorsal heel spur (less often) is a painful bony extension at the heel bone attachment of the Achilles tendon.
The lower heel spur (more common) is a painful bony extension on the inner body of the calcaneus under the heel. So the pain is under the sole of the foot.
The heel spur occurs more often in combination with a so-called Haglund heel. The reason for the combination with this Haglund heel is not entirely clear.
You can find more information about the Fernsporn here: Heel spur - what is it ?.
Synonyms in a broader sense
- Calcaneus spur
- Calcaneus spur
- lower (plantar) heel spur
- upper (orsal) heel spur
- Plantar fasciitis / plantar fasciitis
frequency
At the Heel spur is a common degenerative (wear-related) Illness. The incidence of heel spur disease consequently increases with age. The average age of the patients is between 40 and 60 years. In addition, the stresses from work and leisure activities seem to be lower, which is why one Heel spur rarely requires therapy.
Women are affected slightly more often than men. A heel sponge can be detected in about 50% of the elderly. Not every heel spur needs therapy or causes discomfort.
Figure heel spur
Heel spur - calcaneus spur
(bony outgrowth)
- Lower (plantar) heel spur
- Upper (dorsal) heel spur
- Calcaneal tuberosity -
Calcaneal tuberosity - Heel bone - Calcaneus
- Achilles tendon -
Tendo calcaneus - External calf muscle -
M. gastrocnemius,
Caput laterale - Shin - Tibia
- Fibula - Fibula
- Ankle bone - Talus
- Scaphoid bone - Navicular bone
- External sphenoid bone -
Os cuneiform laterale - Cuboid bone - Os cuboideum
- Sole tendon plate -
Plantar aponeurosis
A - picture of heel with a lower one
and upper calcaneal spur
B - Left foot from the outside
You can find an overview of all Dr-Gumpert images at: medical illustrations
The Heel bone (Calcaneus) is part of the foot and is involved in shaping the lower ankle. Numerous ligaments, tendons and muscles attach to it. The Achilles tendon attaches to its rear (dorsal) part. By pulling the Achilles tendon, the foot be lowered and stand on your toes. Some small foot muscles and the plantar fascia (plantar fascia), which is responsible for the longitudinal arch tension of the foot, have their origin in the lower part of the calcaneus. The heel bone is connected to the tarsal bone towards the front, and to the ankle bone (talus) above via the lower ankle joint.
Appointment with an expert in calcaneal spur?
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Who am I?
My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
Various television programs and print media report regularly about my work. On HR television you can see me every 6 weeks live on "Hallo Hessen".
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Athletes (joggers) are particularly often affected by the disease of the heel spur. In many cases, the cause of the inflammation of the heel spur cannot be identified at first. Therefore, the treatment requires a lot of experience. I focus on the heel spur.
The aim of every treatment is treatment without surgery with a complete recovery of performance.
Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.
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Directly to the online appointment arrangement
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Further information about myself can be found at Dr. Nicolas Gumpert
Cause and origin
The cause of the development of heel spurs is based on increased pressure and tension on the tendon attachments on the body of the calcaneus. This stimulus sets in motion remodeling processes in the tendon fibers, which ultimately lead to a spur-like new bone formation directed towards the foot. The pressure on the heel spur can lead to an inflammatory reaction in the surrounding tissue.
The triggering factors for the development of a heel spur are:
- Age
- Overweight (obesity)
- bad footwear
- Overloads (occupation)
- Foot malformations with elongation of the longitudinal arch of the foot (often: arched flat feet, sometimes splayfoot).
Symptoms / complaints
Patient with a painful (symptomatic) lower heel spurs report stress-dependent pain in the heel area. Depending on the stage of the disease, the pain can only appear after prolonged exposure or be permanent. Typical of the heel spur is also the morning start-up pain under the heel, which initially improves as the day progresses.
The pain character is mostly described as stabbing, occasionally also as burning. A radiation of pain in the foot as well as in the lower leg is possible. To relieve the painful area, the patients sometimes walk over the outside of the foot.
The upper heel spur also causes stress-dependent pain in the area of the Achilles tendon attachment and especially when driving.
Both forms of heel spur can lead to a significant reduction in the level of activity.
Read a lot more on this topic at: Symptoms of Heel Spur
Diagnosis
The medical history (anamnese) of the patient gives the decisive indication of the underlying disease of the heel spur, since the pain is usually indicated very selectively. The pain described can be provoked by pressure a little on the inside of the heel on the sole of the foot.
The suspected diagnosis made in this way is shown in the x-ray of the lateral calcaneus (Calcaneus) mostly confirmed. But there is also the possibility that the classic heel spur complaints first announce the beginning of spur formation and the X-ray image is initially inconspicuous.
An MRI of the foot and sonography are unnecessary for the diagnosis of heel spur disease and are more important in the diagnosis of other diseases. Because of the clear symptoms of the complaint, differential diagnoses are of little importance.
The heel spur through and when jogging
Especially Long distance runner are often affected by a calcaneal spur. This can be caused by the high stress on the heel. But runners who don't run very intensely can also be affected. This mainly applies to Older peoplebecause that Fat pads, which is located under the heel, disappears with age and therefore no longer has a shock-absorbing effect.
If the first symptoms of a heel spur occur while jogging, care should be taken to refrain from jogging in the acute stage until the pain subsides. Long-term care should be taken to ensure a possible cushioning footwear to wear. When buying running shoes, you should make sure that they may have special heel padding. People who belong to the risk group of a calcaneal spur should pay attention to this padding and cushioning as a preventive measure when buying their footwear.
The symptoms of a heel spur usually improve in joggers when they open soft ground to run. If you experience pain when jogging on asphalt, it can be significantly less or not present when running on forest floor. Do enough stretches to warm up before you start running. This is especially true for runners with a heel spur. Especially the calf muscles should be stretched extensively.
Read more on this topic at: Jogging heel spurs.
The therapy options for a calcaneal spur
Tape the heel spur
A heel spur can cause a special tape, i.e. an adhesive bandage, help to alleviate the symptoms. The tape must be stuck in a certain way in order to have a positive effect, which is why it is from Doctors or Physiotherapists should be created. If the tape is attached incorrectly, it can actually make symptoms worse.For taping one Heel spur two strips of kinesio tape are required. The first is placed in the middle under the sole of the foot and along the with the foot extended Achilles tendon Glued up to half the calf. The second tape begins on the outside of the sole of the foot and is stuck over the inner ankle up to half the calf.
The goal of this taping is that the Tendon platethat is under the foot cannot be stretched too far. This avoids constant irritation of the tendon attachment, which can lead to the development and exacerbation of a heel spur. In addition, the continuous gentle pull on the skin promotes the blood circulation and can also help relieve symptoms.
You can find further information under our topic: Taping a heel spur
Home remedies for heel spurs
The simplest home remedy that can be used for heel spurs is cooling. For this, either cooling compresses can be used or ice cubes, with which an ice massage of the foot can be carried out. When using cooling compresses, care should be taken that they do not lie directly on the skin, as this can cause icing. It is better to wrap them in a cloth beforehand. In addition to cooling, the foot should of course be relieved.
Using gel pads under the heel in shoes can improve symptoms while running. However, this is not a permanent solution, because it can lead to incorrect positioning of the foot. Special insoles should be permanently adapted to the individual foot.
In addition, stretching exercises can also be counted among the home remedies. These strengthen the muscles and reduce symptoms in the long term. For example, a cloth can be placed around the sole of the foot while sitting, which is held with the hands. The muscles are stretched by pulling gently. Picking up a cloth with your feet off the floor also strengthens the muscles.
Homeopathic remedies can also be used supportively or alone in the therapy of heel spurs. Here Hekla Lava has proven to be effective. Hekla Lava is a remedy that is extracted from the ashes of a volcano. It should make the body fight inflammation on its own.
Hekla Lava can be used as globules (Globules) can be taken.
Read more about the intake and dosage under: Hekla lava
The self-healing powers of the body can also be supported by magnetic field therapy. Acupuncture can also alleviate the symptoms of a heel spur.
Another home remedy is marmot fat. This is contained in various ointments and has a positive effect on muscles and joints. It is considered an alternative to cortisone. The ointment consists of the fat of the marmots, which is very rich in vitamins. In order to have a positive influence on the heel spur, the ointment should be used twice a day over a longer period of time. Rhododendron ointment is also said to bring rapid improvement in symptoms when used several times a day.
Insoles for a calcaneal spur
In the early stages of a heel spur, it often helps to put gel pads in your shoes under your heel or to wear insoles. However, this is not a permanent solution because one Heel spur is often caused by a misalignment of the foot that should be corrected.
Having insoles made is one of the conservative therapeutic approaches with a calcaneal spur. These can be individually adapted to the feet by the orthopedic technician and often contain recesses or foam rubber linings in the heel area, depending on the load on the heel.
Often lies a Buckle foot or a Arched feet and is in most cases also responsible for the heel spur. The insoles should on the one hand optimize the load on the heel and on the other hand counteract the malposition of the foot. The insoles are shaped in such a way that they support the arch of the foot and give it support. This will make that Arch of the foot straightened and thereby also relieves the heel.
The insoles made can be put into different shoes and thus worn regularly. The complaintsthat the heel spur causes should be considered when wearing the Deposits minimized after about 4 to 6 weeks become or even disappear completely. If this is not the case, or if the insoles are found to be uncomfortable after being worn for a long time, they can also be corrected. This is usually not a problem.
In cases in which the heel spur is very pronounced and causes severe discomfort, it may be that insoles cannot sufficiently lead to an improvement. Then orthopedic health shoes can help alleviate symptoms. These also help to correct any misalignment of the foot and relieve the heel.
Both the cost of the custom-made insoles and the cost of the orthopedic health shoes will be usually covered by statutory and private health insurances. There is only a very small personal contribution that the patient has to bear himself.
Insoles and orthopedic health shoes can alleviate the symptoms and bring an improvement, but should also Measures to strengthen the muscles be taken like about physical therapy or doing exercises independently.
Please also read: Insoles in the heel spur
When is an operation necessary?
Surgery of the calcaneal spur should only be in absolutely exceptional cases be performed. This is very rarely the case, as in most cases an improvement in the symptoms can be achieved through conservative measures. Surgery should be avoided whenever possible as it can bring many complications. It is only performed in about 2% of heel spur cases. In addition, the operation is relatively complex.
An operation can only be performed on a lower heel spur, i.e. a heel spur that is located under the sole of the foot. During the operation, the short foot muscles cut so that the tendon plate under the sole of the foot can be detached from the heel bone. This relieves the tension on the tendon and alleviates the symptoms. In very serious cases, when there is severe inflammation, it can happen that Bone tissue removed must become. Such an operation on the heel spur is not always successful. It can happen that the symptoms persist even after the operation. In addition, undesirable consequences must be expected during an operation. Not only the anesthesia poses a risk, but the subsequent wound healing can also be disturbed and the wound can become infected. It can also happen that the natural fat pad, which is located under the heel and has a shock-absorbing effect, is lost during the operation.
Before deciding on an operation, the conservative measures should be tested. Although these are much more tedious, they are more effective in the long term and involve significantly fewer side effects and risks.
How long does the therapy last?
The duration of therapy for a calcaneal spur is individually different. The conservative measures are usually very tedious, but nevertheless to be preferred, as they are much less risky and more effective in the long term. Acute pain conditions can be avoided by the administration of pain reliever medication be fought in the short term. However, permanent action should be taken against the incorrect loading of the heel that led to the heel spur. The regular performance of exercises to strengthen the calf muscles should be used for several weeks or even months. This is the only way to strengthen the muscles in the long term. Wearing custom-made insoles also requires patience. In some cases, a Improvement of the complaints already after one to two weeks occur, in other cases it takes time up to 6 weeks. Since the heel spur is usually based on a misalignment of the foot, it has developed over the course of many years. The regression and the combating of the symptoms caused by this are therefore also quite tedious.
In most cases, complete healing of a calcaneal spur takes a few years without adequate therapy.
You can find much more information about the duration of the healing under our topic: Duration of a calcaneal spur
forecast
The prognosis for a successful Heel spur treatment is good. Almost always (>90%) a clear symptom relief or freedom from symptoms is achieved. The success of the therapy depends, among other things, on the possibility of physical rest during the treatment period. Since this is seldom possible, phases of suffering lasting several months to several years often arise.
The clinical picture of Heel spur also tends to Relapse (renewed complaints). Even if a conservative or operative therapy Successful recurrence symptoms can occur at any time.
Read more on the topic Voltaren Dispers at our partner.
Figure pain ankle
Foot pain
- Achilles tendonitis /
Achilles tendon rupture - Broken bones - toes,
Metatarsus, tarsus
(here outer ankle fracture) - Ligament stretch / torn ligament
at the ankle - Lower and upper heel spurs
Calcaneus spur - Hammer toe and claw toe
(Deformities of the toe bones)
Digitus malleus - Plantar warts
Verrucae plantares - Hallux valgus -
(Deviation of the big toe
in the base joint) - Hallux rigidus -
(Joint wear of the
Metatarsophalangeal joint) - Inflamed nails / nail fungus
- Osteoarthritis / arthritis -
degenerative change of
Joints / inflammation of the joints
You can find an overview of all Dr-Gumpert images at: medical illustrations
