Heel Pain – Treating Heel Spurs

Have you ever gotten out of bed in the morning and been rocked by agonizing stabbing pain in your heel? The kind of pain that makes you sit right down and wonder how in the blue blazes all those little needles got into your heel? If so, you are probably suffering from a disease whose pain is said to be much like what you might feel if you stepped on a sharp spur.

Dr. Nimrod Ron, Deputy Director of the Orthopedics B Department and a specialist in foot and ankle medicine at Hillel Yaffe Medical Center, explains that this is one of the most common complaints he treats at the hospital's orthopedics clinic and one from which almost 10% of the population suffer from at one time or another. "Plantar fasciitis is a disease that causes heel pain, particularly during the transition from resting to motion and is generally felt right when we get up in the morning," explains Dr. Ron. "The disease popularly known as heel spurs due to the chronic inflammation of the cruciate ligament that connects the heel bone with the base of the toes (plantar fascia). This process creates excess bone in the heel (a small spur). When we walk or stand (apply pressure), we create friction on the heel, causing a sharp pain, as if we stepped on something sharp."

Who is at risk of contracting the disease?

The disease, which equally affects men and women, is attributed to several main causes:

1. People who spend many hours on their feet – work that requires the person to spend most hours standing.
2. Intensive sports, primarily running, jumping and long-distance walking.
3. Feet with high arches. In some conditions, the shape of the foot changes or, alternatively, the cruciate ligament loses its elasticity, resulting in the development of the disease.

How is plantar fasciitis treated?

Treatment is gradual and works on several levels. Sometimes only one type treatment is required and other times a combination of treatments is needed:

1. Physical therapy to make the damaged ligament more flexible. As such, the heel should be massaged at least twice a day – in the morning and evening.
2. Foot supports that support the arch and provide a soft surface for the heel to land on when walking.
3. Anti-inflammatory and pain drug therapy.

Although 80% of patients with this disease will enjoy a full recovery after having undergone the aforementioned treatments, the remaining 20% will require further treatment involving injectable steroids to the heel combined with physical therapy, supports, etc. Patients for whom conservative therapy has failed have several other options available to them, including shock wave therapy and alternative medicine.

Dr. Ron emphasizes, "People need to know that conservative therapy cures the disease for most patients. However, for one percent of patients, the disease is persistent and they will need surgery to perform one of the two procedures:

• Surgical removal of the heel spur formed at the base– i.e. surgical removal of the plantar fasciitis.
• Surgical extension of the plantar ligament that extends the ligament through a minimally invasive procedure. Dr. Ron is proud to claim to be one of the developers of this treatment.

The healing process for plantar fasciitis, whether treated with conservative methods or not, is frequently lengthy (several months to one year), throughout which patients must avoid activities related to walking, jumping or long-distance running. Athletes should switch sports, for example, swimming instead of running.

Can the disease be prevented?

If you are at risk, you should wear shoes with rubber soles or soft soles equipped with shock absorbers, as some sneakers are designed. If you do not want to wear sneakers, purchase the necessary foot supports through a doctor's prescription.

Dr. Ron recommends that people be aware of the importance of early detection and treatment. In other words, if you experience heel pain when walking, go to an orthopedist for treatment. Additionally, do not put off getting treatment following diagnosis. Immediate treatment will help prevent a lengthy recovery.