Spurs can be in many areas of the feet. However, a heel spur seems to be very common. A heel spur would most likely indicate there has long-term subacute inflammation of the area. This is likely caused by abnormal excess pull or tension of the soft tissue. Usually of the fascia on the bottom (plantar) or the achilles muscle/tendon unit on the back of the heel.
So why do some doctors quickly say heel spur and do not further explain?
I think because due to the time crunch, or lack of bio-mechanical knowledge, most patients will respond by thinking, “Now I know why I have pain.” Thus, the doctor does not have to spend more time explaining what is really causing the pain. Again, the cause is typically the abnormal tension resulting in inflammation or degeneration of the soft tissue.
Although there are some systemic conditions that can cause spurs, it is rarely caused by systemic conditions. Some current research questions if there is an additional shearing force on the bone causing the spur. However, the current thought is, the spur is likely caused by inflammation. It is not the bone trying to elongate itself.
Heel spurs can be on the back or bottom of the heel (calcaneous). Many people have them and do not have pain. Also, they do not dissolve from steroid shots as some doctors tell patients.
While taking x-rays for other problems, I’ve identified a large heel spur, sometimes multiple and there is absolutely no complaint of pain. This is typically from the chronic inflammation causing spurring or calcium formation. For example, a football player who is chronically hit in the thigh muscle can develop calcium buildup in the muscle due to the chronic inflammation.
Therefore, if heel pain is present, try to reduce the inflammation and abnormal pull. The pain will typically subside when this is accomplished, eliminating the need for surgery.
David J. Sables, D.P.M., C.Ped
ArchMasters-Orthotics, Shoes & Footcare, LLC