Heel spur (plantar fasciitis) is a disease, the main symptom of which is heel pain. The cause of this pathology, as a rule, is a degenerative inflammatory process in the plantar fascia or, less commonly, a direct trauma by the growth of bone into soft tissues. The plantar fascia is attached to the calcaneal tuber, a place that experiences tremendous stress in the upright position, which is why micro-fractures often arise here, which normally quickly regenerate. Sometimes, due to frequent trauma, chronic aseptic (non-infectious) inflammation occurs and bone proliferation forms popularly referred to as heel spur. The heel spur looks like spikes. This disease is more common in women after the age of 40, although it may occur at any age.

Causes of heel spurs

Factors provoking pathology:

• overweight;
• high-heeled shoes;
• excessive mechanical pressure on the foot (in professional athletes);
• abnormalities in the structure and development of foot bones;
• gout;
• presence of arthritis;
• arthrosis;
• foot injuries;
• diseases of the structure of the spinal column;
• circulatory disorders in the lower extremities;

Clinical manifestations

Symptoms of the heel spur appear almost immediately with the development of the pathological process in the foot. The main signs of disease:

• pain in the foot;
• increased pain symptom during loading of the foot (running, jumping);
• with the development of the disease, foot pain becomes constant;
• sharp, cutting pain;
• burning sensation in the foot;
• soothing of pain during the course the day, intensification in the morning after waking up and in the evening;
• deterioration in general condition due to calcium deposition;
• gait change;
• difficulty and pain while walking.

Diagnosis

The signs of the disease are specific. For making the correct diagnosis, it is enough to examine the patient and examine his medical history. Additional diagnostic methods include:

• X-ray
• MRI
• Ultrasound (prescribed during treatment to assess the positive dynamics of therapy).

 

Treatment

Treatment methods are selected by the doctor individually, depending on the stage of development of the pathology, the severity of clinical picture and physiological characteristics:

• exercise therapy;
• wearing of orthoses;
• use of orthopaedic insoles;
• laser therapy;
• administration of glucocorticoids;
• ultrasound;
• cryodestruction;
• x-ray therapy;

Regardless of which treatment method is chosen, the patient needs to limit the degree of load on the heel. Conservative treatment involves the use of topical medications (Diclofenac, Ibuprofen), physiotherapy, ultrasound, laser, and shock-wave therapy. The disadvantage of conservative therapy is the long duration of treatment, the need to take painkillers throughout it, the lack of a guarantee of a stable good result, discomfort and limitations during therapy (for example, orthoses firmly fix the foot at an angle to the lower leg and are used at night, which affects the quality of rest and sleep).

To alleviate the general condition of the patient, in the absence of a positive effect from conservative therapy, a blockade is made. However, it has only a temporary effect, as it relieves inflammation, but does not affect the cause.

The MedClinic Medical Center uses a relatively new, but well-established non-surgical method for treating this pathology – radiofrequency treatment of the attachment site of the plantar fascia with high-frequency pulses.

The advantages of this method:

• performed on an outpatient basis, under local anaesthesia;
• persistent positive effect after one procedure;
• minimal risk of side effects and complications;
• the duration of the procedure is 10-15 minutes;
• a great alternative to surgery.

If drug treatment did not give the desired result, minimally invasive methods of treating spurs are resorted to. An extreme measure is the excision of the heel spur, open or endoscopic. An operation is performed only when other procedures and medications are not able to reduce the pain syndrome.

For the treatment to have a positive trend, the patient must follow preventive measures – wear comfortable shoes with orthopaedic insoles, limit the load on the heel as much as possible and refuse to do active sports.