Member Case Study: Heel Spurs

author : AMSSM

comments : 0

I have a heel spur in my right foot, and it is progressively getting worse and worse. I would like to have it removed through surgery, but wonder if this is the right thing to do?

Member Question from bctri21

"I have a heel spur in my right foot and it is progressively getting worse and worse. I would like to have it removed through surgery, but wonder if anyone here has gone through that? My podiatrist told me to quit running if it hurt, but there was no noticeable difference when I stopped running.  Should I go under the knife and hope I recover? I am 28 and would like to continue running and doing triathlons throughout life."

Answer from Ron Hanson, MD CAQSM
Member AMSSM

Your heel spur is likely not the cause of your problem. It has been thought previously that spurs on the heel were the cause of pain, but this idea has generally fallen out of favor. In fact, we see spurs all over the body. When a spur forms where a tendon meets a bone, it is called a traction spur. Bone is extremely active tissue that is able to respond to stresses placed upon it. When there is a lot of stress where the tendon (or in this case, the plantar fascia = a tendon-like structure) interfaces with bone, the body sometimes augments the interface by turning part of the soft tissue into bone. It is thought that there may have been degenerative or inflammatory changes preceding the spur formation, but this is not completely known. It is common to see degenerative changes in the tendon with imaging when spurs are present. When proper steps are taken to heal the degenerative tissue, the pain (but not the spur) usually goes away.

A careful look at your range of motion, the way you walk, the balance of your musculature, and your neurologic function along with appropriate imaging (I prefer ultrasound) will give you more information as to the source of your pain and the cause of the problem. Shoe changes and orthotics are often helpful.  Knowledgeable staff at a running store are a good source of information and suggestions. If your problem is degeneration at the point where the plantar fascia meets the heel bone, I suggest: calf stretches for 2-3 continuous minutes 2-3 times per day, eccentric calf exercises (you’ll need to Google this or see a sports medicine physician), and robust massage of the area that hurts 5-10 minutes 2 times per day. If you do not improve, you’ll need to be evaluated.

Good Luck

Ron Hanson, MD CAQSM
The Centeno-Schultz Clinic
Center for Regenerative Medicine
403 Summit Blvd Ste 201
Broomfield, CO 80021
Clinic: 303-429-6448

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date: October 11, 2010