Calcaneal spur (plantar fasciitis) is a chronic pathology that negatively affects the patient’s lifestyle. Excruciating pain is caused by bone growth - an osteophyte that squeezes the surrounding soft tissues. It is a pointed spike, the size of which can reach 12 mm. The neoplasm is often imperceptible externally, but to determine its presence simply by pressing on the heel area. In the ICD, the heel spur is presented under the code M77.3.
Development mechanism
The plantar fascia is a fibrous tissue or ligament connecting the calcaneus with the metatarsal elements. She is responsible for maintaining the longitudinal arch of the foot. When walking or running, the tissues of the plantar fascia take the greatest load in the area of its attachment to the heel tubercle. Normally, this kind of microtrauma independently overgrows and regenerates. However, a constant effect on the fascia is often the cause of the transformation of the periosteum.
The pathology development mechanism may be associated with:
- microtrauma of ligaments;
- the development of aseptic inflammation in the area of damage;
- irritation with increased loads on the calcaneus.
In places of inflammation, salts gradually accumulate, forming an osteophyte or calcaneal spur.
Main reasons
More than 2 million people see a doctor every year with symptoms of plantar fasciitis. Moreover, 70-80% of them are women, whose age is just over 40 years old. Doctors identify several reasons for the development of the pathological process. Among them:
- flat feet;
- age-related changes associated with impaired blood supply to the limbs and with a decrease in tissue regenerative abilities;
- pregnancy period;
- overweight;
- vascular disease of the lower extremities (diabetes, gout or rheumatoid arthritis).
In young men, sports training and wearing uncomfortable shoes can become the cause of heel spurs.
Symptoms and stages of development
The formation of an osteophyte may be asymptomatic if the cause of its development is permanent. In this case, the pathology is detected by chance, for example, during an X-ray examination according to other indications. However, most often plantar fasciitis is characterized by a pronounced clinical picture.
The first and most important symptom is a feeling of discomfort in the heel when walking. Its appearance is due to the pressure of the bone growth on the soft tissues. The intensity of the pain syndrome is more dependent on the location of the growth, rather than on the size. It will be much stronger if the osteophyte is localized near the nerve endings.
At the first stage, the pain may disappear for an indefinite time, but after it necessarily appears. First, discomfort occurs in the morning, when a person gets out of bed and takes the first steps. Then it increases with increasing loads. If untreated, the pain remains even at rest. It becomes cramping in nature.
The second symptom of the heel spur is a consequence of the first: a person's gait changes. When discomfort in the heel appears, the patient tries to unload it involuntarily. Improper distribution of the center of gravity of the body to the foot also provokes the development of flat feet. Particularly noticeable is the change in gait when spurs are present simultaneously on both legs.
Diagnostic Methods
If a person knows what a heel spur looks like, he has all the signs of a pathology, he should immediately consult a doctor. A surgeon, orthopedist or rheumatologist is involved in the treatment of such diseases.
However, an accurate diagnosis, based only on a physical examination and patient complaints, is not possible. Calcaneal pain often indicates other disorders. It can be ankylosing spondylitis, osteomyelitis, gout or rheumatoid arthritis. Therefore, in addition to studying the history, the doctor should prescribe a comprehensive examination. Usually it includes:
- blood tests;
- urinalysis;
- MRI of the foot;
- roentgenogram.
The last examination method is considered the most informative. On the roentgenogram, osteophytes are always clearly visible.
Therapy options
How to treat heel spur? In each case, the treatment option is selected by the doctor individually. It is worth noting that in modern practice it is customary to combine them. Traditional methods of eliminating pathology include drug and non-drug therapy. In the latter case, we are talking about laser treatment, ultrasound. In especially serious situations, surgical intervention is required. Good results give folk recipes. Consider what each of the treatment options is in more detail.
Drug use
The main drugs for calcaneal spur are various ointments and gels, which include non-steroidal anti-inflammatory components. These include Diclofenac, Butadion, and indomethacin ointment. These products are intended for external use. They have an analgesic and anti-inflammatory effect. Drugs should be rubbed into the affected area 4 times a day. The duration of such treatment should be at least 2 weeks.
To eliminate the pathology, a special patch based on herbal painkillers is also used. It is glued to a dry surface of the skin, leaving for 2 days. The course of treatment is also at least 2 weeks.
In the absence of a positive effect from external means, the doctor may recommend blockade of the heel spur. During the procedure, injections with glucocorticoid hormones are injected into the affected area. The blockade allows you to quickly get rid of the pain syndrome. In this case, only 2-3 procedures are sufficient. However, they should only be performed by a surgeon. With the wrong dosage of the drug, complications may develop. We are talking about strengthening the inflammatory process, the formation of suppuration. Too frequent procedures can damage or destroy fascia tissue.
Physiotherapeutic Impact
Various physiotherapy procedures help to reduce pain discomfort and improve blood movement in the foot:
- irradiation with ultraviolet light;
- electrophoresis using potassium iodide;
- magnetotherapy;
- therapeutic baths.
Doctors also recommend orthopedic insoles for calcaneal spur. They fix the foot well, while the heel itself remains in a slightly elevated position, which reduces the intensity of pain.
Shock wave therapy
This method is used relatively recently, but has already managed to prove its effectiveness in the treatment of heel spurs. Shock wave therapy helps to relieve inflammation in the soft tissues. The established frequency of the ultrasound wave acts on the affected area, while loosening the existing salt deposits. Then they are washed out of the body along with a blood stream.
Small spurs are well eliminated by this treatment method. Therefore, you should not endure pain and always postpone a visit to the doctor. In advanced cases, this treatment method helps to stop the progression of the disease.
Shock wave therapy for heel spurs has some contraindications. Her help should not be resorted to for arrhythmias, hypotension, thrombophlebitis, oncopathologies, and during pregnancy.
Using a laser
Laser treatment has the same operating principle as UVT: the laser beam eliminates inflammation, relieves pain and swelling. During the procedure, the doctor sees through the affected area from several projections with a beam whose power is 80 mW. To get a positive result, you must complete 2 ten-day courses, but the interval between them should be one week.
X-ray therapy help
First of all, it should be noted that x-ray alone is not a panacea. X-ray treatment of spurs is permissible only in combination with other methods of therapeutic treatment. This approach allows you to fight the inflammatory process and has a quick analgesic effect. However, without the use of appropriate medications, treatment will be incomplete and slow.
The degree of exposure is minimal, therefore, X-ray therapy is recommended to be carried out in courses of 5-10 procedures. This treatment method is not suitable for everyone. It will have to be abandoned during pregnancy, because even small doses of radiation can adversely affect the development of the fetus.
Surgical intervention
About how to treat heel spur with traditional means was described a little higher. Their main goal is to stop unpleasant symptoms. Surgical intervention is aimed at getting rid of the growth itself, but it does not exclude cases of its reappearance. Therefore, they resort to it only in especially serious situations.
The volume of surgery depends on the nature of the pathology. During the procedure, the plantar fascia is cut partially or completely, and then the spur itself and damaged tissue are removed. With complete fasciotomy, the anatomy of the foot is impaired. As a result, gait changes cause disability.
Home treatment
With severe pain in the foot, you should immediately visit a doctor. What to do if a doctor is unavailable? In this case, you can stop unpleasant symptoms with the help of improvised means. For example, medical bile, laundry soap, and even compresses with salt help with heel spurs.
One of the simplest methods of treatment at home is to apply a magnet to the affected area. Keep in this position as long as possible. According to patient reviews, after 15 procedures, pain is reduced.
With heel spur, medical bile has proven itself well, more precisely, compresses based on it. Before starting the procedure, the legs should be steamed in a warm bath. Chamomile broth, sea salt or aromatic oils can be added to the water. After about 15 minutes, the feet should be wiped dry. A cotton swab is moistened in medical bile and applied to the site of inflammation. It is better to wrap a leg with a layer of polyethylene, and then apply a bandage. It is important to leave such a compress overnight.
Iodine has a warming effect, therefore, improves blood circulation. As a result, inflammation and pain gradually subside. Doctors consider the treatment of heel spurs with iodine a dubious method, because it is very difficult to get rid of osteophytes only with it. This tool helps soften bone formations, but to enhance the therapeutic effect, it is necessary to use variable approaches to eliminate pathology.
Help traditional medicine
Among the folk remedies for the treatment of heel spurs, potato compresses take the first place. The root crop needs to be peeled and grated. The resulting mass should be applied to the heel, and a bandage on top. It is necessary to keep such a compress for no more than 4 hours, and repeat it every day.
To eliminate puffiness, ordinary household soap is used. It must be grated on a coarse grater and dissolved in water. The liquid should be beaten to a state of foam, and then lubricate the sore spot with it. This method of treatment is suitable even for pregnant women.
Propolis is a natural product that contains many trace elements. To treat spurs, you need to take a small piece of it and soften it. For this purpose, you can use a water bath or microwave. After softening the propolis, it is necessary to make a pancake from it and apply it to the affected part of the foot, cover with gauze on top. Such a bandage is recommended to be worn during the day.
Treatment of heel spurs with folk remedies is best done under the supervision of a doctor. In addition, traditional medicine should not be neglected. Prescriptions for folk healers must be used as an adjunct to the main therapy.
Prevention Methods
Methods for the prevention of plantar fasciitis can be generalized under one abbreviation - HLS. There are several directions for the prevention of this disease:
- body weight control;
- prevention of premature aging of the articular apparatus;
- prevention of traumatic injuries;
- timely diagnosis and treatment of all pathologies of the supporting system.
In pregnant women, the risk of developing plantar fasciitis is quite high. It is due to physiological changes that occur in the body. It is about softening the ligaments during pregnancy. Therefore, women in position need to think in advance about the prevention of pathology. It comes down to daily foot massage and wearing comfortable shoes. If the disease could not be avoided, the most gentle treatment methods (ointments and patches) are prescribed. Also, with calcaneal spur, orthopedic insoles are an indispensable treatment option.