What is Heel Spur and how does it occur?
Contrary to popular belief, heel spurs are not actually a bone disease, but are 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 rheumatic event in the sole of the foot is called plantar fasciitis. 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 a heel spur.
What kind of complaints does a heel spur cause?
The most important symptom 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, only MRI and sometimes ultrasound imaging can detect edema and thickening of the basement membrane. 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 it is resistant to treatment.
What kind of treatments are used for heel spurs?
The treatment of heel spurs is generally done with conservative methods. . Very special stance Surgery has no place, except for Antirheumatic 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. In stubborn cases, cortisone injection in the heel is useful. Although short-term results are good, there is a tendency for recurrence approaching 40-50%. Not being able to make the injection in the right place also plays a role in this. Therefore, these types of injections should be performed with ultrasound imaging. Although shock wave called ESWT has started to be used frequently in recent years, its results are worse than cortisone injection and it is not preferred because the patient may feel pain during the procedure.
PRP in the treatment of heel spurs
PRP is the abbreviation of the initials of the English expression "Platelet Rich Plasma" and means "platelet 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 liquid stimulate the cells of the structures in the plantar fascia and heel spur area where the injury occurs, accelerating the healing in that area.
Recent studies have reported satisfactory results, especially in heel spur cases where other treatments failed. It is generally applied once, sometimes twice, with a month interval. PRP treatment is a method that has already been proven to be effective in joint rheumatism such as knee and hip and tendon rheumatism such as tennis elbow. We can now say that heel spurs and plantar fasciitis are also within the scope of use of PRP treatment.
Of course, all treatments and PRP treatment should be supported by activity modification and appropriate exercise program. PRP treatment continues to be a new hope for many stubborn musculoskeletal diseases.
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