Most of us know that the heel is the largest bone in the foot and that when the heel hurts, the whole foot can hurt. A number of issues can cause heel pain, but perhaps one of the most common is a condition known as a heel spur.
A heel spur occurs when a calcium deposit causes an abnormal growth on the bottom of the heel bone (calcaneus). X-Rays show that these hook-like protrusions may extend as much as half an inch forward. The actual heel spur itself is frequently painless, but can be the cause of pain in the heel if inflammation occurs at the area of the calcium deposit. Though related, this pain is not from the spur itself, but from resulting soft tissue damage. Heel spurs are often associated with plantar fasciitis, which is a painful inflammation of the plantar fascia, the connective tissue running along the bottom of the foot to connect the calcaneus to the ball of the foot. The pain associated with heel spurs and plantar fasciitis is often described as a sharp, stabbing pain in the bottom of the foot when first standing up out of bed in the morning, which later fades into a dull ache.
The calcium deposits that make up heel spurs are often formed by strains on the muscles and ligaments of the foot, stretching of the plantar fascia, and multiple or repetitive tears in the membrane covering the calcaneus. In addition to high-impact exercise, like running and jumping, risk factors may include: abnormalities in walking, especially when additional force is applied to the heel area; inadequate shoes, especially those lacking proper arch support; and excess weight or obesity. A higher percentage of women develop heel spurs than do men, mostly likely because of footwear that forces the feet into unnatural shapes and positions. Heel spurs are most common among middle aged folks, but can occur in any age group. Wearing well-fitting and activity appropriate shoes that have not been worn down in the heels may be the best step towards preventing heel spurs, but warming up or stretching before activity and pacing yourself are also helpful options.
Treatment for heel spurs may include special exercises, anti-inflammatory medications, custom orthotic insoles, or cortisone injections. If these treatments fail, surgery may become necessary.