Emilie Kristek
If you live to be a hundred, I want to live to be a hundred minus one day so I never have to live without you.


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Emilie Kristek

Author:Emilie Kristek
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What Are The Primary Causes Of Calcaneal Spur
Posterior Calcaneal Spur


Overview


Heel spurs are a relatively common cause of heel pain. A heel spur is a pointed bone fragment that extends forward from the bottom of the heel from the heel bone, also referred to as a calcaneous. Serious pain and discomfort often develops with this condition. In many cases, a heel spur develops along with plantar fasciitis which occurs when the plantar fascia ligament becomes inflamed.


Causes


Heel spurs develop as an abnormal growth in the heel bone due to calcium deposits that form when the plantar fascia pulls away from the heel. This stretching of the plantar fascia is usually the result of over-pronation (flat feet), but people with unusually high arches (pes cavus) can also develop heel spurs. Women have a significantly higher incidence of heel spurs due to the types of footwear often worn on a regular basis.


Heel Spur


Symptoms


Most heel spurs cause no symptoms and may go undetected for years. If they cause no pain or discomfort, they require no treatment. Occasionally, a bone spur will break off from the larger bone, becoming a ?loose body?, floating in a joint or embedding itself in the lining of the joint. This can cause pain and intermittent locking of the joint. In the case of heel spurs, sharp pain and discomfort is felt on the bottom of the foot or heel.


Diagnosis


Heel spurs and plantar fasciitis are diagnosed based on the history of pain and tenderness localized to these areas. They are specifically identified when there is point tenderness at the bottom of the heel, which makes it difficult to walk barefoot on tile or wood floors. X-ray examination of the foot is used to identify the bony prominence (spur) of the heel bone (calcaneus).


Non Surgical Treatment


Rest won?t help you in case of pain from the heel spur. When you get up after sleeping for some time, the pain may get worse. The pain worsens after a period of rest. You will feel pain because the plantar fascia elongates during working which stresses the heel. It is important to see a doctor if you are having consistent pain in you heel. The doctors may advise few or all of the conservative treatments, stretching exercises, shoe recommendations, shoe inserts or orthotic devices, physical therapy, taping or strapping to rest stressed muscles and tendons. There are some over-the-counter medicines available for treatment of heel pain. Acetaminophen (Tylenol), ibuprofen (Advil), or naproxen (Aleve) are some such medicines which can help you to get relief from the pain. In case of biomechanical imbalances causing the pain, a functional orthotic device can help you to get relief. Your doctor may also advise a corticosteroid injection for eliminating the inflammation.


Surgical Treatment


Surgery involves releasing a part of the plantar fascia from its insertion in the heel bone, as well as removing the spur. Many times during the procedure, pinched nerves (neuromas), adding to the pain, are found and removed. Often, an inflamed sac of fluid call an accessory or adventitious bursa is found under the heel spur, and it is removed as well. Postoperative recovery is usually a slipper cast and minimal weight bearing for a period of 3-4 weeks. On some occasions, a removable short-leg walking boot is used or a below knee cast applied.

What May Cause Calcaneal Spur
Calcaneal Spur


Overview


Bone spurs usually form around joints that have arthritis, in the vertebrae of the spine, and on the heel. When they form on the heel, they may form on the back of the heel but usually form on the bottom of the heel. Of course, this is where all of the body weight comes down with each step. Spurs on the bottom of the heel are usually most painful the first few steps out of bed each morning. The pain may lessen somewhat after walking for a few minutes, but may be intense again after sitting for a half hour or so, such as after lunch. The pain usually gets worse throughout the day as you are up on your feet more. Often the pain feels like a nail being driven through the heel into the ankle and leg.


Causes


A major cause of heel spur pain comes from the development of new fibrous tissue around the bony spur, which acts as a cushion over the area of stress. As this tissue grows, a callus forms and takes up even more space than the heel spur, leading to less space for the thick surrounding network of tendons, nerves, ligaments and supporting tissue. These important structures in the foot have limited space because of calcium or tissue buildup, which leads to swelling and redness of the foot, and a deep throbbing pain worsened with exercise.


Calcaneal Spur


Symptoms


Heel spurs result in a jabbing or aching sensation on or under the heel bone. The pain is often worst when you first arise in the morning and get to your feet. You may also experience pain when standing up after prolonged periods of sitting, such as work sessions at a desk or car rides. The discomfort may lessen after you spend several minutes walking, only to return later. Heel spurs can cause intermittent or chronic pain.


Diagnosis


Because the diagnosis of heel spurs can be confused with tarsal tunnel syndrome (as described earlier), most surgeons advocate performing a tarsal tunnel release (or at least a partial tarsal tunnel release) along with the plantar fascia release. This surgery is about 80percent successful in relieving pain in the small group of patients who do not improve with conservative treatments.


Non Surgical Treatment


To aid in the reduction of inflammation, applying ice for 10-15 minutes after activities and the use of anti-inflammatory medications, such as aspirin or ibuprofen, can be helpful. Corticosteroid injections may also be used to reduce pain and inflammation. Physical therapy can be beneficial with the use of heat modalities, such as ultrasound, that create a deep heat and reduce inflammation. If the pain caused by inflammation is constant, keeping the foot raised above the heart and/or compressed by wrapping with a bandage will help. Taping can help speed the healing process by protecting the fascia from reinjury, especially during stretching and walking.


Surgical Treatment


Surgery involves releasing a part of the plantar fascia from its insertion in the heel bone, as well as removing the spur. Many times during the procedure, pinched nerves (neuromas), adding to the pain, are found and removed. Often, an inflamed sac of fluid call an accessory or adventitious bursa is found under the heel spur, and it is removed as well. Postoperative recovery is usually a slipper cast and minimal weight bearing for a period of 3-4 weeks. On some occasions, a removable short-leg walking boot is used or a below knee cast applied.


Prevention


To prevent this condition, wearing shoes with proper arches and support is very important. Proper stretching is always a necessity, especially when there is an increase in activities or a change in running technique. It is not recommended to attempt working through the pain, as this can change a mild case of heel spurs and plantar fascitis into a long lasting and painful episode of this condition.