General Information About Heel Spurs
What is a Heel Spur and how does it occur?
Contrary to popular belief, heel spurs are actually a disease. It is not a bone disease, but a condition that occurs as a result of chronic damage to the membrane called plantar fascia on the sole of the foot. Thanks to the depression in the inner part of every person's foot, called the long arch of the foot, the loads on the foot are distributed evenly, preventing excessive load on soft tissues and bones. As a result of the collapse of the arch of the foot, excessive standing, long walks and poor shoe habits, the sole membrane called plantar fascia, which supports this arch, becomes overstretched. Due to chronic injury, thickening of the plantar fascia and soft tissue edema occurs, especially where it attaches to the heel bone. This phenomenon in the sole of the foot is called plantar acid. As the disease progresses, this membrane begins to thicken and chronic injuries occur at the point where it attaches to the heel bone. The body tries to reduce stress by creating new bone in this area. When this bone structure is pointed, it is called heel spur. What kind of complaints does a heel spur cause?
The most important symptom of a heel spur is pain. This pain is especially bothersome in the mornings. When the patient wakes up in the morning, he cannot step on his heel for a while. As the disease progresses, morning pains begin to spread throughout the day. Shoes with hard soles and high heels can be uncomfortable. In severe cases, standing becomes uncomfortable at any time and the pain may even continue at rest.
How is heel spur diagnosed?
Heel spur has not yet developed. Diagnosis can be made with a good examination when plantar fasciitis does not occur. At this stage, edema and thickening in the basement membrane can be detected only with MRI and sometimes ultrasound imaging, but in daily outpatient clinic practice, there is no need to take an MRI to make the diagnosis. When a heel spur forms where the membrane adheres to the heel bone, a simple x-ray is sufficient to make the diagnosis. An important point to remember is that underfoot pain and heel spurs may be the first signs of inflammatory spinal rheumatism. This disease should be investigated, especially if there is pain behind the heel and if it is resistant to treatment.
What causes heel spurs? What treatments are used?
Conservative Treatment:
The treatment of heel spurs is generally done with conservative methods. Non-steroidal anti-inflammatory drugs, activity restriction, and shoe modification may be sufficient in mild cases. Special insoles and heel supports with holes in the heel may be useful.
Cortisone Injection:
In stubborn cases, cortisone injection through the heel can be applied. Although short-term results are good, there is a possibility of recurrence. Care should be taken to make the injection at the right point.
ESWT:
ESWT is based on the principle of sending intense shock waves from outside the body to the affected area. It is a treatment method that has become very popular recently. It is generally applied in 3-6 sessions. It can be applied in combination with other conservative treatment methods and cortisone injection.
PRP:
PRP is the abbreviation of the initials of the English expression "Platelet Rich Plasma" and means "platelet rich plasma". It means "rich plasma". In this method, it is a natural treatment method since the medicine is prepared from the patient's own blood. The high growth factors contained in PRP fluid stimulate the cells of the structures in the plantar fascia and heel spur area where the injury occurs, accelerating the healing in that area.
Surgical Treatment:
In the treatment of heel spurs, surgical treatment can be applied in cases where all conservative treatment methods have been tried and no results are obtained. In surgical treatment, the granulation tissue and bone protrusion in that area are removed. Its success is quite high.
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