Make every step count—treating heel spurs and plantar fasciitis

  • Shelly Webb
  • January 11, 2012
  • 292
                        
Summary- While many times overlooked and endured, problems with the feet can affect the entire body and the way you feel. Taking time to see a podiatrist can help you make every step count. Story- Many individuals are diagnosed every year with foot issues. One of the most common is known as heel spurs. A heel spur is normally painless however other conditions connected to the spur may produce pain. Plantar fasciitis is a separate condition that can be related to heel spurs. Together, these two foot issues can wreak a lot of havoc. While heel spurs and plantar fasciitis are related, they are not the same. Plantar fasciitis refers to the inflammation of the plantar fascia--the tissue that forms the arch of the foot. A heel spur on the other hand is a hook of bone that can form on the heel bone. About 70 percent of patients with plantar fasciitis have a heel spur that can be seen on an X-ray. Local Podiatrist, Dr. John McLaughlin DPM, said that although the word ‘spur’ is used, the condition actually involves bone that has formed over time and is caused from the manner in which an individual walks. “The spur, if present is bone that has formed slowly over time due to instability in the way a person walks,” he said. “The instability is inherent and generally present from the time a person starts to walk. The joint that is important for stability is the one below the ankle.” McLaughlin said the presence or absence of a spur is evident only with an x-ray. Knowing whether or not a spur is present can be helpful, but a heel spur is not normally the cause of foot pain. “The spur itself is not painful, and it does not cause pain,” he said. “The pain, in most cases, is caused by inflammation of a ligament attached to the spur. This ligament is known as the plantar fascia. What can cause the plantar fascia to become inflamed is usually something relatively minor. Most people don't experience a major injury that starts the inflammation, and in normally our bodies are very capable of healing the inflammation. However it is a difficult part of the body to heal because we are constantly putting our weight on it with every step we take.” Even taking small baby steps will still aggravate a plantar fasciitis, but ‘walking’ is a part of the daily routine so it’s difficult sometimes to find relief. “I tell our patients that you don't have to run a marathon to aggravate it, just day-to-day normal activity will do it,” McLaughlin added. “People who have instability will have a more difficult time in healing the inflammation because instability puts abnormal amount of tension on the plantar fascia to begin with, so there is constant aggravation to a part of the body that is already inflamed. This situation makes it very difficult to gain improvement.” The only way to heal the ligament is to minimize the abnormal strain being put on it. Some common sense ways to minimize the strain include wearing good shoes and using anti-inflammatory medications. “Minimizing the abnormal strain on the ligament will help allow our bodies to heal the inflammation,” McLaughlin explained. “Patients need to avoid going barefoot, and wearing sandals, flip flops and other shoes that aren’t supportive. Instead you want to wear good, supportive shoes that are sturdy around the back of the foot, and have a sturdy sole. Sometimes over-the-counter supports can be helpful too, but they are non specific, therefore limited in their effectiveness.” In addition to good shoes and over-the-counter remedies, there is also the option of custom molded orthotic devices as well as taping and padding the foot. “If people are wearing good shoes all the time, and have tried supports without success, then they may need custom molded orthotic devices for maximum support,” McLaughlin said. “The lab we use has many years of experience in making devices specific for each individual foot type based on the way we take the impressions. In addition to adequate support, other things such as taping and padding, stretching and massage may also help with these foot conditions. Also, anti-inflammatory medications, oral and at times injections do offer relief and can make a difference in a patient’s condition.” According to McLaughlin, surgery is a last resort, and is not to address any spur but instead is performed to release the ligament that is attached to the spur. He also said that in 90-95% of the cases plantar fasciitis and heel spurs respond well to adequate support and non surgical treatment. There are only very few cases in which surgery is recommended or needed for this condition because the spur is not a problem. The inflammation causes the pain and the inflammation can be treated with more support and anti-inflammatory medications. As a rule, people don’t always seek treatment for sore, aching feet, but seeing a podiatrist can help you address problems early on before they become worse. Treatment is available so you’ll have no problems putting your best foot forward every day.


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