It is estimated that 10% of US residents shall, at least once in their life, complain of heel pain. Of these, 83% shall belong to the active population, namely between the ages of 25 and 65. The most common cause is found in an osteophyte, namely, a bony protrusion which is thought to form at inflammation sites or chronic irritation sites of the tendons and denervations. In literature, this osteophyte, like a spine in the front of the heel, is called the heel spur, and, at a rate of 50%, coexists with plantar fasciitis, namely the inflammation at the point where the plantar fascia, the dense fibrous tissue band which runs from the heel and reaches up to below the heads of the five metatarsal bones.

Studies have shown that the heel spur is associated with age (it more often occurs in the 40-60 age groups), excessive pronation and limited dorsal flexion of the foot, but also with obesity. Additional risk factors include regular weight-lifting, prolonged standing, a sharp increase in the activity levels, and even the wrong shoes which do not provide adequate foot support. Especially in long-distance runners, the heel spur is considered to be associated with injuries due to overuse, in combination with training errors, sports fields, muscle dysfunction and stiffness. The high-risk groups also include jumpers, ballet and contemporary dance dancers.

Usually, patients describe that the pain is more intense in the morning, when they try to take their first daily steps, and worsens when they lift some weight. Moreover, it may appear when they spend a long time standing, when they attempt to stand up after a long period in a seated position, but also after exercise, and not during the exercise itself. Describing the type of pain, they underline that it feels like they are stabbed in the foot, near the heel.

Εάν η άκανθα πτέρνης μείνει χωρίς διάγνωση ο πόνος γίνεται χρόνιος και επηρεάζει την καθημερινότητα του ασθενούς, ο οποίος προσαρμόζει ανάλογα τον τρόπο βάδισης με αποτέλεσμα στη συνέχεια να εμφανίζονται προβλήματα στο πόδι, το γόνατο, το γοφό και τη μέση. Η διάγνωση γίνεται με τη λήψη πλήρους ιστορικού και με κλινική εξέταση.

If the heel spur is left untreated, the pain becomes chronic and affects the patient’s daily routine, who adjusts their walking style accordingly, resulting in leg, knee, hip, and waist problems. Diagnosis is performed through the obtaining of a complete clinical history and examination.

Conservative treatment is recommended for most patients. Regarding the treatment of pain and inflammation, anti-inflammatory drugs are prescribed, while ice can provide relief as well. Strengthening of the Achilles tendon and the plantar fascia, as well as of muscles which stabilize the ankle and heel take place through physiotherapy and special exercises. During sleep, the patient is advised to wear a night splint, while it is highly probable that the orthopaedist shall also suggest the design of special insoles, in order for the pressure to be uniformly distributed.
If the pain does not subside after a few months, steroid injections can provide temporary relief, although they are not preferred in many cases of patients, as they can weaken the plantar fascia and lead to a disruption. The relatively new growth factor therapy also offers good results. Moreover, there is the possibility to remove the scar tissue of the plantar fascia without surgery. Surgery in the heel spur does not seem to be an option anymore.

Do you need a
Second Opinion

Are you sure about the diagnosis and the treatment that has been suggested to you? Fill in the form below to request a second opinion from Dr. Konstantinos Indzoglou.

    Make an

    And we will contact you!

      Add testimonial description here. Edit and place your own text.

      John Doe


      Add testimonial description here. Edit and place your own text.

      Jane Doe


      need help?

      Lorem ipsum dolor sit amet, consectetur adi pisicing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua.