Definition
The heel spur is an exostosis of the calcaneus, that is a benign bone formation that develops in the posterior area of the heel.
The heel spur depends on inflammation at the level of insertion of the Achilles tendon on the heel (enthesopathy), which causes a deposit of calcium salts; this pathological process, of a degenerative nature, develops very slowly.
The disorder is similar to the heel spur, with the difference that the latter begins with the insertion of the plantar ligament.
The heel spur is closely related to chronic diseases, such as plantar fasciitis and osteoarthritis. Factors that can predispose to the disorder are anatomical features (eg hollow or pronated feet), repeated microtraumatism in athletes, excessive weight and prolonged use of unsuitable footwear that involves constant stress on the hindfoot.
Most common symptoms and signs *
- Foot pain
- Heel pain
- Swollen and tired feet
Further indications
The heel spur can be asymptomatic, but it usually causes acute pain localized to the heel. Often, this symptom gets worse under load, during the journey. Pain tends to decrease, however, with bed rest.
The heel spur also causes tension in the muscles and ligaments, which can develop into inflammation, with swelling and heat in the affected area.
X-ray examination of the foot can highlight this bone process, especially in the lateral projection. For a better differential diagnosis, it is recommended to perform an ultrasound scan of the surrounding soft tissues or of an MRI scan.
The treatment involves taking NSAIDs and performing stretching exercises on the calf muscles and the soft parts of the foot. Other measures may include the use of braces and orthoses to allow proper loading in the step and weight loss in overweight patients.
In the most serious cases, physical therapy (tecarterapia, massages, ultrasounds and lasers) may be useful, possibly associated with local infiltration.
In patients who have not benefited from conservative therapy, surgical removal of the spur may also be indicated.
