Bone spurs sound like a nasty condition that needs to be corrected immediately. It’s easy to picture a sharp piece of bone poking into nerves and tissue as a source of your foot pain.
But don’t jump to conclusions. Bone spurs in the heel (more often called heel spurs) are actually a symptom of a different condition called Plantar Fasciitis, which is the true culprit. Fortunately, treatments to reduce the pain of this condition and eventually cure it are easy, inexpensive, and will help 90% of sufferers find relief within a year. And for most of those people, with proper care and treatment, the condition will resolve even quicker, in three to six months.
What Causes the Pain?
The type of bone spurs that may develop in response to Plantar Fasciitis (PLAN-ter Fash-ee-EYE-tis) are called enthesophytes. This type forms at the attachment point for a tendon or ligament, unlike osteophytes which form in the spaces of a joint.
The ligament involved is called the plantar fascia. “Plantar” just refers to the bottom of the foot, while “fascia” is a type of connective tissue. The plantar fascia is the broad band of tendon-like tissue along the bottom of your foot, connecting your heel bone to the base of your toes. It is an important part of the structure called the “arch” of your foot.
This arch is what allows you to walk with a typical gait, where you come down on your heel, and then propel yourself forward onto your toes. Actually, the entire system involves your calf muscles and Achilles tendon in addition to the plantar fascia. All three, when kept limber and healthy, work together to keep a spring in our step.
But when the plantar fascia is subjected to excessive stress and strain, the normal little rips and tears of daily life get ahead of the body’s healing processes. The small tears become bigger, the tissue can start to pull away from the bone, and inflammation occurs. The pain you feel first thing in the morning is the plantar fascia’s response to its first little stretch of the day with all those injuries still waiting for proper treatment.
Bone spurs, or heel spurs, may occur at the point where the plantar fascia attaches to the heel bone. When the ligament repeatedly pulls on this attachment to an abnormal degree, or actually begins to separate, the normal response is for more bone to grow to correct the problem. That’s the heel spur—just a tiny little piece of calcification that is an attempt to correct the problem of Plantar Fasciitis.
Our modern lifestyle works against us sometimes, especially when it comes to taking care of our feet and legs. Instead of regular physical exercise in fields and forests, we spend most of our time walking on cement and hard floors, or sitting behind a desk. This leads to a cascade of factors that put us at risk for damaging the plantar fascia and resulting bone spurs in the heel:
- Weight: we all know there’s an obesity crisis in America, and that it’s spawning an epidemic of diabetes and other health issues. One of those issues is Plantar Fasciitis. With the arch of the foot under the strain of excess weight, it’s much more likely to develop rips and tears that can’t heal fast enough to recover.
- Tight calf muscles: without enough exercise or due to wearing inappropriate shoes, our calf muscles can become so short that they interfere with the proper motion of walking. The arch of the foot takes a disproportionate share of the load while walking or running in this situation.
- Bad footwear: it’s not just women’s high heels that are considered unhealthy footwear. If you don’t have a long history of walking barefoot over uneven, soft surfaces, your plantar fascia is not “trained’ to absorb shock as efficiently as it was meant to. To compensate, today’s urbanized population needs to pay attention to shoes that provide extra cushioning, adequate arch support, and good toe flexibility. When you go from wearing stiff, flat shoes at work all week to flip-flops or bare feet on the weekends or vacations, you’re setting yourself up for an unpleasant episode of Plantar Fasciitis and potentially bone spurs on your heel.
- Extreme activity: professional athletes subject their feet to enormous shocks and loads, but the weekend warrior can easily make the same mistake in a pickup game of basketball. If you lead a basically sedentary life with spurts of sports or other exercise, it’s very important to stretch carefully and thoroughly every time you undertake an activity.
Whether your doctor says you have heel spurs or Plantar Fasciitis, or is unable to make a diagnosis right away, he or she will probably recommend the following treatments to start. This condition is usually always treated conservatively for a number of months before even considering more invasive remedies like injections or surgery.
In addition to the treatments suggested here, it’s important to make the lifestyle changes that will prevent further damage to your plantar fascia. Losing weight, exercise, and always stretching before any exercise will go a long ways toward keeping your feet pain free after you’ve cured the agony of bone spurs in your heel.
Ice and Rest
Plantar Fasciitis begins as a “soft-tissue” injury, and these two treatments can work wonders. But most people can’t just sit around holding ice on their foot all day. As a compromise, try to refrain from any activity that causes the pain to flare, or that you can feel is extending the bottom of your foot—climb stairs slowly, and crab-wise if possible; no running or jumping; if you must stand, sit frequently and gently massage your feet, ankles, calves. If in doubt—don’t do it.
When using ice on your foot, remember to always add a barrier between it and your flesh. It’s easier than you think to freeze your skin and tissue, and that will only compound your problems. A lot of people find the best success with a frozen can of vegetables that they roll under their foot for 5 or 8 minutes at a time, a few times a day. Look online for special wraps that are designed to be unobtrusive at work, with a cold gelpack inside to reduce the pain and inflammation in your foot.
Stretching the calf muscles and Achilles tendons can be a very effective cure for Plantar Fasciitis, as well as help prevent a relapse. The reason is that taking a step with tight calf muscles translates into an excessive snapping force on the bottom of your foot. You may not feel it with each step, but over time the tissue in your plantar fascia will start to become degenerative and weak.
Because most sufferers report their greatest pain in the morning upon getting out of bed, night splints are a way to provide a gentle stretch while you sleep. They hold your foot in a gently extended position overnight to prevent the plantar fascia from retracting during this long period of inactivity. There are many styles of splints to choose from—consult with your doctor or podiatrist about which one to try first.
Anti-inflammatory medication like Aleve, Ibuprofen and plain old aspirin will help relieve some of the pain and inflammation that causes it. A few products deliver this relief directly at the source of the pain in the form of medicated creams.
Other ways to reduce inflammation are to elevate the foot, or to compress it by standing on the edge of a thick book.
Tape and Inserts
Athletic tape is often used as a sort of home-made orthotic by isolating, immobilizing and supporting different areas of the foot. You can figure out a taping regimen yourself, as long as it relieves the pain, but you can also find detailed instructions online or ask your doctor for help in coming up with a pattern.
There are also many types of shoe inserts available in stores or online to help your shoes deliver the kind of support that will relieve pain and prevent injury. Heel cups are one of the most effective remedies of this sort.
For a certain percentage of people, the above treatments will not cure the pain caused by their Plantar Fasciitis and bone spurs in the heel. But there is still a chance that custom orthotics.
Get a referral from your primary care physician to see a podiatrist for a more thorough exam of your problem. Whether the podiatrist fashions orthotics (shoe inserts) for you, or sends your prescription to a laboratory for manufacture, the quality and effectiveness of the devices will be vastly greater than anything your doctor can supply. It is not unheard of for an over-the-counter or mass-produced orthotic to hurt more than help a Plantar Fasciitis case, so if you’ve moved on to this step, invest in a quality product. Again, if the orthotic causes you more pain or does not relieve your pain, let the podiatrist know as soon as possible for another evaluation.