A heel spur is a bony growth that develops at the rear or bottom of the heel bone. Also known as calcaneal spurs or osteophytes, these small, bony protrusions often develop without any obvious symptoms, and may not cause pain or inflammation for months or years. On an X-ray, you can often see a heel spur extend by as much as 1/4 of an inch, but in this initial stages of discomfort, these growths may not even appear on an X-ray.
Diagnosing a heel spur can be difficult, as it is often mistaken for plantar fasciitis, which is inflammation of the tendon that connects the heel bone to the toes. Many people often suffer from both of these conditions simultaneously, particularly when the heel spur occurs on the bottom of the calcaneous bone (heel bone). When a heel spur develops on the back of the heel, it is more commonly associated with the Achilles tendon or inflammatory conditions of tendonitis. Some people also develop a heel spur all by itself, without any connection to another inflammatory condition.
Causes of Heel Spur
A heel spur can have a number of causes, including excess calcium deposition, a strain on the foot ligaments, repetitive physical activity, various inflammatory diseases, obesity, improper shoes and gait issues.
Most cases of heel spur occur because of damage or inflammation to the foot ligaments; when this damage or strain is perceived, more calcium depositions are formed to support the ligament, which can lead to the bony outgrowth on the bottom or back of the heel bone.
An excess amount of calcium in the body can speed the process of heel spur formation, in much the same way as gout and other inflammatory conditions can be exacerbated by an excessively high level of calcium in the blood.
Repetitive Physical Activity
For athletes who regularly jump or run in their respective sports, heel spurs can be quite common. That constant impact on the heels, arches, and ligaments of the feet will cause inflammation and potentially speed the development of this condition.
If your frame is carrying around more weight than it is designed for, the responsibility for that extra weight often lies in the feet. Obesity can put a lot of strain on ligaments and muscles, leading to chronic inflammation in the legs and feet, which is why obese people often suffer from this condition.
As we age, the tissues, bones, and ligaments in our body naturally begin to break down or weaken, and cannot be replaced fast enough. This can lead to inflammatory conditions, such as arthritis, and can also contribute to the calcium deposition that leads to heel spurs.
Wearing shoes that don’t fit properly or don’t provide adequate support is a very common cause of a heel spur. If your shoes are too loose, too tight, or don’t support your arches, it can lead to inflammation in the tendons and ligaments in your foot, which increases the risk of a heel spur. Furthermore, wearing high heels or flip-flops very often can put you at a higher risk.
The way you walk can cause a heel spur to develop, particularly if you are flat-footed, bow-legged or are pigeon-toed. These types of gait can increase strain on the plantar fascia and Achilles’ tendon, making you more susceptible to heel spur growth.
Symptoms of Heel Spur
The symptoms of a heel spur may be difficult to identify, as this condition only causes pain in approximately 50% of people who suffer from it. Some of the most common symptoms include a sharp stabbing pain, like a knife or pin being pushed into the heel, followed by a dull aching in that area of the foot. The symptoms are particularly obvious when you first rise in the morning, or when you stand up after sitting down for a lengthy amount of time.
These symptoms arise because of increased blood flow to that area of the body, which can inflame the damaged tissue area, causing it to press against the heel spur. The deposition of calcium that causes a heel spur is your body’s way of supporting the ligaments and tendons (plantar fascia, Achille’s etc.), but it ends up leading to more pain when the heel spur jabs into the delicate tissue of the heel pad.
As mentioned, however, almost 50% of people don’t experience any negative discomfort or inflammation as a result of a heel spur, and may not be aware of its presence until it is large enough to require surgical removal. Once a heel spur grows large enough, it can be felt beneath the skin, and may even be visible as a small protrusion beneath the foot or on the back of the heel.