Symptoms of calcaneal spur: how and with whom is this disease manifested and how to cure it?
Heel spur, or plantar fasciitis is a degenerative disease of the plantar fascia, which causes pain in the heel area, caused by the proliferation of bone tissue in the form of a spine( which, in fact, is called a calcaneal spur).In this article, you will find out what kind of disease it is, who it occurs, what symptoms are manifested, and what are the methods of treating this ailment.
Why does heel spur?
Who gets this disease. Risk factors.
Symptoms and signs of illness + video
Treatment: heel pads, medicines, physiotherapy, curative gymnastics, surgical treatment
Why does this disease occur?
Although the heel spur is often referred to as a synonym for plantar fasciitis, this is not entirely true. Plantar, or plantar fascia - is a connective tissue formation( you can say - a bunch) that supports the longitudinal arch of the foot. Well, since the weight of our whole body lies on the foot, by and large, it turns out that almost all the time the weight in 50, 70, or even 100 kilograms weighs on this longitudinal fascia!
spur or plantar fasciitis( scheme)
Therefore, it is not surprising that, due to such a large load on it, small micro-snaps occur occasionally from the fascia. Usually, these microtraumas are healed on their own, but in some cases this does not happen, and aseptic inflammation( ie, inflammation without the participation of bacteria) of the fascia itself, as well as nearby formations, including the calcaneus, occurs. And the heel bone reacts to aseptic inflammation in the same way as it happens with deforming arthrosis of the joints: bone tissue proliferation( formation of marginal osteophytes) by the type of bone spines. So there is a disease, which is called the heel spur in the people. Who has this disease?
Most of all, the appearance of the calcaneal spur affects middle-aged people( after 40 years), and mostly women. It is not yet possible to find out exactly why this is happening and why some people have plantar fasciitis and others do not. But at the same time, the factors that trigger the onset of this disease are known.
- flat feet( longitudinal);
- is overweight;
- dystrophic diseases of the joints of the legs, mainly large ones - such as arthrosis of the knee joint, osteoarthrosis of the hip joint, etc.;
- leg injuries, in particular - calcaneus injuries, which often "trigger" the development of the calcaneal spur;they can be both acute and chronic;
- metabolic disease;
- presence of diseases in which blood circulation in the legs is disturbed( diabetes mellitus, etc.);
- significant and prolonged loads in the heel area( especially often in athletes);
- diseases of the spine( Bechterew's disease, uncovertebral osteoarthritis, etc.);
- inflammation of various joints( arthritis), reactive arthritis, etc.
pain in the heel area - the first symptom of the spine
The main and main symptom of the heel spur are heel pains that occur during movement, which increase with walking and physical exertion, andalso after a prolonged state of rest( the so-called "starting pain").
Usually these pains are especially pronounced in the morning, in the morning. The pain in the heel is sharp, sudden and sharp. In order to reduce it, the patient can use a cane or try to attack mainly on the toe of the diseased leg.
According to what signs the doctor diagnoses
Usually, in order to make such a diagnosis, an experienced doctor does not need a lot of time. As a rule, for this purpose it is enough to carefully examine the patient and find out when and how he has pain, and also to examine the area of the heel and make an x-ray of the patient's foot. Usually on such an X-ray image with the naked eye can be seen the growth of the calcaneus in the form of an acute spine( see the figure), which, in fact, causes painful sensations.
x-ray of calcaneal spur
If the pain in the calcaneal region is there, and the X-ray examination does not show the presence of a spur, the doctor, in order to make the correct diagnosis, will have to exclude other diseases of bones and joints, primarily rheumatoid arthritis, as well as reactive arthritis.
But, as a rule, the statement of this diagnosis still does not cause difficulties for the doctor. And after he is delivered, it's time to start treating this disease.
Therapy of this disease should be comprehensive and conducted immediately in several ways. There are several types of treatment for calcaneal spurs: non-drug methods, medicinal methods, physiotherapy and therapeutic gymnastics, as well as surgical treatment.
Non-pharmacological treatments for
horseshoes to reduce pain in the spine
Since microfractures of the longitudinal fascia are an important factor in the development of the disease, it is very important to ensure that they do not occur, walking is most comfortable for the patient, and physical stress on the foot is not too great.
First of all, this is achieved using the use of special orthopedic insoles, and the use of special non-rigid liners with a special groove in the center of the heel - so that the soft tissues around this bone growth are not injured.
Since the main symptom of this disease is pain, the heel spur is prescribed anesthetic non-steroid drugs, which are designed to both reduce pain and reduce inflammation in the fascia and calcaneus zone. To this end, it is prescribed, for example, ibuprofen or diclofenac.
In addition to medications for calcaneal spurs that are ingested, various external ointments and gels are often used, which help to further reduce pain, but due to local action, they do not give the body side effects typical for NSAIDs.
medication spurs only by
doctor. In cases where pain can not be defeated with drugs from this group, more powerful hormonal drugs are used. Since they have rather strong side effects when administered internally, with a calcaneal spur they are usually prescribed as injections directly into the heel and the plantar fascia. Usually, in order to reduce pain and inflammation, one or two injections of such hormonal agents as diprospan or hydrocortisone are sufficient.
Please note: these preparations are presented in this article for informational purposes only! Do not self-medicate: this can lead to serious consequences. To treat the heel spur, you need to seek medical treatment internally!
In addition, there are quite effective folk methods for treating the calcaneal spur. Wise nature has created medicinal plants, decoctions and infusions of which can help to reduce pain in the foot, reduce inflammation, improve the nutrition of tissues in the diseased area. The main thing - do not forget that any methods of treating the spur of folk medicine must necessarily be coordinated with the attending physician. These methods of healing are useful only if they are carried out in parallel with medical treatment: it is only with the help of folk treatment that the spur does not pass!
Physiotherapy and Curative Gymnastics
Shockwave Therapy for Plantar Fasciitis
Therapeutic exercises with a calcaneal spur help to train the plantar fascia in such a way that micro-ruptures do not form. To do this in the morning, special therapeutic exercises are carried out, designed to stretch and strengthen the fascia in a special way, so that its resistance to injury is increased.
A special place in the treatment of the calcaneal spur is physiotherapy. A good effect is provided by such procedures as greeotherapy( peloid-therapy), special therapeutic mineral baths, ultrasound therapy, Vitafon apparatus treatment, laser therapy and other methods. But the most effective method of treating spurs, especially when the bony outgrowths have reached a large size, is shock wave therapy. In this procedure, the bone growth( spur) is destroyed by a special narrowly directed source of sound that is beyond the audibility of a person.
In those rare cases when all of the above methods have not helped to cope with the disease, one has to resort to a surgical or surgical method of treatment. During this procedure, excision and removal of the bony outgrowth is performed, which traumatizes the surrounding tissues.
However, the earlier a patient discovers the symptoms of a calcaneal spur and turns to a doctor, the more likely the disease will be stopped by conservative methods and dispensed with without surgery.
Do not delay coming to the doctor, this will help you avoid unnecessary pain and again become a healthy person!
Heel spur - clinical picture of the disease
- 3 Prevention of development of the calcaneal spur
- Causes, signs and symptoms of calcaneal spurRating of the article: 5.00 / 5( Votes: 1)
Bony overgrowth, shaped like a spine or wedge,bones in medical practice is called calcaneal spur. Many patients compare the pain that occurs in the process of development of the pathological process with a feeling that arises when, by carelessness, step on the heel of the nail.
This condition is caused by the pressure of the formed bone build-up on the soft tissues of the foot located in the heel area.
Causes of the disease
Consider the most common causes of calcaneal spurs:
Plantar fasciitis in common people is called "heel spur" In almost 90% of cases, this pathological process develops due to flat feet. This is due to the fact that in patients suffering from flatfoot, there is a redistribution of the load on the foot, the tendons are stretched, and sometimes( in severe cases) some tendon fibers break from the underlying pits. As a result, not only tendons become inflamed, but also the surface layer of bone tissue located under them.
- Acute or chronic injury of the calcaneus.
- Pathologies that are associated with a metabolic disorder( in particular - gout).
- Circulatory disturbance in the lower limbs due to poor permeability of blood vessels.
- Arthritis, polyarthritis or Bechterew's disease.
- Age changes.
- Significant load on the feet( with intensive sports).
- Excess body weight.
- Diseases of the spine.
Symptoms and Diagnosis
Heel spur is a pathological formation that can form on one or both feet. In this case, the pain is localized on the inside of the heel or spread throughout its surface.
Symptoms of the disease:
- The main symptom of the calcaneal spur is the pain that develops in the heels( usually with support).The most painful are the first steps after the morning awakening, and also such "starting pain" appears after a long break in movement. During the movement, painful sensations subside, but by the evening they return with renewed strength.
- Due to the fact that the pain in the heel is very intense, the person involuntarily tries to relieve the affected foot, which, of course, affects his gait. It is especially difficult for those patients whose spurs are formed on both heels. Due to the fact that the center of gravity is transferred to the outer edge of the foot and its front sections, a transverse flatfoot develops.
- When visual examination is often very difficult to notice the pathological changes in the calcaneal region, but when pressing on the hillock of the calcaneus( from the plantar side), as well as squeezing the heel from the sides, characteristic pain is noted.
- Another symptom of the calcaneal spur is the thinning of the subcutaneous fat layer in the heel, which acts as a kind of shock absorber when walking.
However, pain in the foot, localized in the heel area, may not always be a manifestation of the calcaneal spur. Therefore, to clarify the diagnosis it is necessary to consult a specialist. Unfortunately, not all patients know for sure which doctor heals the heel spur.
Note: treatment of calcaneal spurs is performed by an orthopedist or surgeon.
When examining a specialist, first of all, it is necessary to exclude other pathologies that can form in the heel area( Bechterew's disease, Reiter's syndrome or rheumatoid arthritis).
To this end, biochemical blood tests( for determination of rheumatoid factor) are mandatory in the process of the study. The immediate presence of the heel spur is determined by X-ray diagnostics.
The dimensions of the formation may be different, but this indicator does not determine the intensity of pain. As a rule, painful sensations depend on the sensitivity of the tissues. This is why an additional ultrasound examination is often required.
Ultrasonic soft tissue of the foot is necessary for choosing the method of treatment
Thus, the symptomatology of the disease is caused not by the presence of the pathological formation itself, but by changes occurring in soft tissues. This can be a phenomenon of periostitis, inflammation of deep mucous bags, as well as plantar fasciitis( inflammation of the plantar fascia, which is a band of fibrous tissue located along the sole).According to the authoritative opinion of specialists, this pathology is a prerequisite for the development of the heel spur.
"heel spur" disease is a very insidious disease, which in 25% of cases can cause loss of mobility. Therefore, in the development of intense pain, the patient is transferred to easy work, and also bed rest can be assigned to him. It is especially difficult in this case for athletes who can no longer maintain their habitual life rhythm.
Prevention of development of calcaneal spur
In order to prevent the occurrence of a pathological process, it is necessary to prevent the development of inflammation in the soft tissues of the foot.
Overweight patients are recommended to lose weight in order to reduce their foot load.
Recommendation! Disease heel spur, which arose due to flat feet, provides for wearing comfortable foot that does not hurt the foot. Very well proven orthopedic insoles.
At the same time, specialists in the prevention of prescription gymnastics for the feet, and also recommend to do foot massage. Walking on sand or on grass is very useful. Such procedures help improve blood supply to the feet, preventing the development of the pathological process.
Who gets a spur and why
The processes occurring in the foot are a bit like degenerative-dystrophic processes in the joints that cause arthrosis. Healing of microtraumas, obtained due to increased load, occurs in the bundles of the foot with the involvement of bone tissue in this process. The growth of marginal osteophytes in the foot does not initially cause many problems, but over time these processes are aggravated and can cause disability.
According to statistics, this disease affects mainly women aged 40 years and over. Recently, the frequency of appearance of bone growths has increased, and young people have become sick. Moreover, it is proved that heel spur is not an independent disease, but appears as a consequence of other pathological processes taking place in the body.Until the end of the mechanism of the appearance of this disease is not detected, but noted some factors, the presence of which increases the risk of disease.
- Formation of longitudinal flat feet( causes a calcaneal spur in 90% of all cases).Excess weight.
- Mechanical injuries of the foot and its calcaneus( fall, stroke).
- Dystrophic changes in the joints of the legs.
- Disturbance of metabolic processes.
- Increased load on the foot( for athletes).
- Inflammatory processes in the joints.
- Diseases of the endocrine system( diabetes, thyrotoxicosis).
- Inconvenient and incorrectly selected shoes.
Know the early symptoms and treatment of the heel spur, which should be performed immediately when these signs appear - a pledge that the sick person will not sooner or later be bedridden.
Symptoms of calcaneal spur are difficult to confuse with other diseases, since the sharp end of the spur is 3 to 12 mm long pointed towards the fingers and even slightly curved. This structure of osteophytes causes sharp and painful pains, intensifying when walking, as if a person stepped on the tip of a needle.
How to identify the disease
One of the symptoms of the heel spur are pain in the heel area. But these pains have their own characteristics, knowledge of which will help to recognize the disease in time and in the early stages to seek help.
Early signs of
- The appearance of pain during long sitting and in the mornings, which gradually subsided for lunch. These pains are also called "starting" pains, since most patients note them, but rarely consult a specialist for help when they appear.
- The nature of the pains, which subsided for lunch and renewed with renewed vigor in the evening, also refers to early signs.
- Sudden pains in the heel, which have the character of "shooting" for no apparent reason. If these signals are heard at rest, and there was no trauma or other provoking factor - you know, this is a sign of the calcaneal spur. Such pain in rest does not arise because of the presence of the spur, but as a result of the onset of inflammation.
- Change of gait, which is noticed by close people, but the patient does not feel yet. The person involuntarily at occurrence of a dyscomfort in the field of a heel transfers the center of gravity on stop. This eventually can cause transverse flatfoot. This change in gait occurs when the size of the osteophyte is large, since the pain is dull and not sharp.
The diagnosis is made on the basis of an X-ray, where the bony growths are clearly visible. Which doctor treats the heel spur and by what methods is it treated - read on.
The heel pads help avoid pain when walking.
The earlier a patient turns to a doctor, the more likely that he will not have to resort to surgical methods of therapy. Of course, it is better to start treatment with a search for the reasons, since the proliferation of bone tissue appears as a consequence of these provoking factors. The disease is treated by an orthopedist who must take into account all the nuances( age of the patient, degree of overgrowth, symptoms, etc.) in order to prescribe a comprehensive therapy.
Among all available treatments are the following.
- Non-pharmacological methods are performed with the help of special insoles. Orthopedic insoles with a calcaneal spur are made in such a way that in the heel area they have a small groove that prevents the occurrence of pain during walking. Hindquarters with heel spurs are shown to be worn in the initial stages of the disease.
- Drug therapy - for the purpose of anesthetics and the treatment of inflammation, non-steroidal anti-inflammatory drugs( diclofenac, ibuprofen and others) are prescribed inside, and the use of ointments with a similar formulation for topical application. If the disease is started, such treatment is unlikely to have an effect, then resort to hormonal therapy( diprospan, prednisolone).It is better to inject hormones in the form of targeted injections( directly into the heel area).In addition to medicines, folk remedies that have anti-inflammatory properties are used in parallel. So, for example, a good resorption effect has a medical bile with a heel spur, which is applied in the form of applications.
- Physiotherapeutic methods of therapy, massage and therapeutic gymnastics with a heel spur - a set of exercises is used to strengthen the ligaments of the foot. Widely used methods of therapy, such as laser treatment, ultrasound, mud baths, shock wave therapy( for large osteophyte sizes).Massage with a calcaneal spur also helps to strengthen the ligamentous apparatus of the foot.
- Surgical treatment of the calcaneal spur - is used only in cases when conservative methods do not give an effect. Before removing the heel spur, you need to make sure that you have used all the existing methods, and only then resort to the operation.
In conclusion, we recall that an early address to a doctor and a timely treatment start that the growth of osteophytes in the heel can be stopped. Agree, because our health must be paid on time, so as not to mourn then!
Heel spurs .or plantar fasciitis, is a chronic microtrauma of the plantar ligament that connects the calcaneus to the anterior part of the foot.
As a matter of fact, the heel spur looks like a small, but nevertheless very unpleasant on sensation spiky growth on the sole of the foot and is an osteophyte( bone growth) on the surface of the calcaneus. This sprouting appears in the form of a spine and, when loaded, compresses the soft tissues of the foot. This causes characteristic painful pains.
Often, especially in the early stages of the disease, it is difficult to detect such a spur. Sometimes this happens only during an X-ray examination. On an x-ray, this area is similar in density and brightness to bone tissue. Therefore, it seems that he continues the heel bone and looks like its pointed protrusion or spine. Heel spurs can be of various sizes. Most often its length is from 3 to 12 mm. The sharp end of the growth usually looks in the direction of the toes and slightly bent upwards.
Causes of calcaneal spur
Modern medicine believes that the heel spur is formed as a result of the following reasons :
- high load on the heel area, for example, with flatfoot,
- due to age changes,
- at a young age - as a result of significant loads on the foot in classsports and overly intensive training,
- with excess weight,
- as complications of injuries, rheumatism, vascular disorders or pathologies associated with nerve damage in the lowerf course.
In 90% of cases, calcaneal spurs develop against the background of flat feet. The reason for this is that with flatfoot changes the load distribution on the bones of the feet, which causes too much tension of the tendons. The consequence of this is their easy traumatization under any sufficiently strong impact when walking - small stones or roughness of the soil.
After the injury, inflammation occurs, which is accompanied by pain. In the area of ligament ligament, its fibers are replaced by scar tissue. This fabric does not have high strength and elasticity, and therefore often becomes the site of the following damages. In particularly severe cases, certain tendinous fibers can even completely detach from the bones to which they are attached. As a result, the inflammation captures not only the tendons themselves, but also the surface layer of bone tissue located beneath them.
Age-related disorders of
In elderly people, the development of this disease is mainly associated with age-related changes and prolonged stress on the lower surface of the foot. All this, coupled with reduced ability to regenerate tissues, as well as age-related disorders in the blood supply of the lower limbs and leads to the development of a calcaneal spur.
Sport and training
Heel spurs are pathologies that are characteristic not only for elderly patients. Young people develop it most often with intensive training and frequent training. Such sports as, for example, running, jumping, etc.always imply increased stress on the osteo-ligamentous apparatus of the foot and do not exclude the appearance of its micro-injury.
Overweight, which is one of the most characteristic diseases for a modern person, also causes an increased load on the feet when walking. In addition, fat people are much more at risk of foot injuries arising from uneven ground.
Common diseases of the body
The reason for the formation of the calcaneal spur can be acute and chronic traumas of the calcaneus, as well as pathologies associated with metabolic disorders in the body, for example gout. In addition, the development of this disease can lead to significant circulatory disorders in the lower extremities in patients with poor vascular patency, for example, in diabetes mellitus.
The formation of the heel spur can also be the result of a number of chronic inflammatory joint diseases .rheumatoid arthritis. Bechterew's disease, etc. The pathologies of the large joints of the lower extremities and the spine disrupt the normal distribution of the body's weight when walking over the surface of the foot and the risk of developing calcaneal spurs increases.
Quite often the heel spur is accompanied by inflammatory processes in the mucous bags of the foot( achillobursitis or subclavian bursitis) and inflammation of the fascia - the shells of the foot muscles( fasciitis).
As early as the beginning of the 20th century, this disease was very rare and in most cases it was caused by trauma, not flat feet or overweight. But in the modern world heel spur has become a very common disease. According to statistics, in 80% of cases it affects women, and more than half of them are residents of cities.
Diagnosis of calcaneal spur
Usually this diagnosis does not cause any special difficulties when staging. It is based on typical enough complaints :
- pain in the heel area in the mornings after a night's sleep,
- pain in the heel after periods of rest and rest,
- pain arising after running or long walking,
- gradual reduction of pain sensations,as the patient paced,
- the emergence of local soreness when you click on the area of inflammation.
To confirm the diagnosis, an X-ray examination is usually performed. However, the calcaneal spur in most cases is detected accidentally by X-ray examination of patients who do not even complain. Therefore, it is believed that the presence of such a spur does not yet mean disease. It can be just an individual feature of the structure of the foot of a particular person. And if it does not deliver any unpleasant sensations and does not increase with time, then usually such a spur does not need treatment. Also, it is not uncommon for some patients with severe heel pains to show no spurs on the X-ray. In this case, the cause of complaints should be sought in other areas.
Symptoms and symptoms of calcaneal spur
The most common symptom of the calcaneal spur is the appearance of acute, burning pain while supporting the heel. Often, patients describe it as a feeling of "nail in the heel."Pain is caused by pressure of bone formation on soft tissues. In this case, the intensity of pain depends little on the shape and size of the build-up. Quite often sharp and large heel spurs are not felt by the person, and flat and small are very painful. The intensity of pain is more closely related to the location of the build-up than to its size. In addition, the closer the spur is located to the nerve end of the foot, the more painful it will be.
In the future, pain can occur without stress. This is due to the fact that scar tissue, formed at the site of the injury with time, begins to accumulate insoluble calcium compounds. These deposits cause irritation of surrounding tissues, mucous membranes of articular bags, bone elements and, as a result, inflammation, which is also accompanied by a characteristic pain syndrome.
The most common disease develops after the age of 40 years. One of the first signs of a calcaneal spur is pain while supporting the heel. Particularly painful are the first steps after getting up from bed in the morning or after long breaks in traffic - the so-called "starting pains".During the day, when walking, the pain subsides somewhat, and by the evening, with the accumulation of fatigue and stress, again intensifies.
Pain can spread to the entire surface of the foot or be present only from the inside of the heel. Therefore, the patient involuntarily tries to unload the heel area, which affects his gait. It is statistically determined that with a calcaneal spur in 93% of cases there are violations of the nature of gait.
In this case, the transfer of the center of gravity from the heel to the outer edge and the forefoot causes an incorrect distribution of body weight and leads to the development of transverse flatfoot. In cases where heel spurs develop on both legs, it becomes particularly difficult for such a person to move.
An additional factor that increases pain in the heel spur is the thinning of the subcutaneous fat on the heel, since this layer acts as a natural shock absorber when walking.
How do I determine if I have a calcaneal spur?
If you mark pain on the feet in the foot of the heel - this does not mean that you have heel spurs. To clarify your diagnosis, you need to contact a surgeon.orthopedist and rheumatologist. First of all, it is necessary to exclude other diseases that have similar painful manifestations in the heel area: rheumatoid arthritis, Bekhterev's disease and Reiter's syndrome. These diseases are diagnosed with the help of biochemical blood tests - it reveals specific rheumatoid factors. The very presence and size of bone growth is determined by X-ray examination. But the intensity of the pain depends no more on the size of the spur, but on the sensitivity of the surrounding tissues and the proximity of the nerve endings. Therefore, to refine the diagnostic data, it is recommended to supplement X-rays with ultrasound.
Heel spur in children
Bunches of the foot are usually not yet strong enough to resist prolonged and effective loads. Therefore, children who are overweight, intensively engaged in sports or grow rapidly, are always at high risk of forming heel spurs. In addition, until the age of 16-18 years, the baby's foot is still very plastic and easily deformable. This leads to rapid and frequent flatfoot development. Also, with intensive growth of the child, which requires an increased intake of energy and building material, his joint-ligamentous and bone apparatus may suffer from a shortage of nutrients. Often this leads to the development of diseases of the spine and foot.
The most important thing is shoes!
It is important to select children's shoes, taking into account the anatomical features characteristic of each of the ages. For example, for the first steps, when children still have a fat pad on the arch of the foot, it is better to buy shoes with ordinary even insole and a heel level raised by 2 cm.
Later, depending on the condition of the foot and the individual needs of the child, you need to select shoes, which will perform preventive functions or use orthopedic insoles. The sole of any children's shoes for everyday wearing should not be completely flat, as, for example, with a sneaker or ballet shoes. But the heel should be selected not more than 3 cm in height. It is necessary to teach the foot of a child to quality footwear from the very early childhood. And one more tip: do not use worn sandals and shoes, because each child's foot tramples the insole strictly individually.
Therapy for calcaneal spur in children
All such decisions related to footwear for children should be taken only after examination and with the assistance of an orthopedic physician.
If the child has already formed a calcaneal spur, then treatment should be started as soon as possible. Due to the stiffness of the gait, resulting from painful sensations in the heel and foot, the child can quickly develop scoliosis.violation of posture.inflammation of the joints of the lower extremities. The program of heel spurs therapy in children practically does not differ from that of adults, but often the cure comes much faster. This is due to the fact that the children's body has much more opportunities to repair damaged tissues.
Treating the calcaneal spur
Can I heal the heel spur?
Of course, yes! Currently, there is a very wide choice of ways to effectively heal spurs :
- providing unloading of the foot by using various types of thrusts and insoles,
- ultrasound therapy,
- mineral baths,
- X-ray therapy,
- in the absence of effects - surgical treatment, which consists in removingbone build-up by surgery and excision of altered tissues.
In most cases, the treatment of the calcaneal spur is conservative and depends on the cause of the disease.
Shock Spine Shock Wave Therapy
Shockwave therapy is a relatively new method of treatment. In our country, this procedure began to practice not very long ago, but the first results are already encouraging. Of course, it is not yet possible to judge the effectiveness of this method of treatment unambiguously, since there is still no opportunity to study the long-term results of therapy.
The available experience allows us to state that the effectiveness of getting rid of the heel spur is very high when using this method of treatment. The method is based on the action of pulses of ultrasonic waves of a certain frequency. The shock wave effect of ultrasound loosens calcium deposits in the heel spur. This allows later to wash the loosened deposits from the body with the bloodstream. The affected ligament is thus rid of accumulated calcium salts.
In addition, the processes of tissue regeneration are activated, puffiness and inflammation are reduced. With each procedure performed, the pain syndrome becomes less and, as a rule, completely disappears by the end of the treatment. The affected area in many ways restores its natural structure and regains the ability to tolerate everyday loads without causing painful sensations. In the initial stages of the disease heel spur is completely eliminated, and with a long duration of the process, deposition in a bunch of calcium compounds stops and inflammation is removed.
However, it is not possible to carry out shock-wave therapy for everyone. Contraindications to the treatment of calcaneal spur by ultrasound are :
- bleeding disorders,
Spur calcaneus - Causes, symptoms and treatment. MF
Heel spur is the growth of bone tissue on the calcaneal surface, which looks like a spike. The heel spur is located more often on the plantar surface of the calcaneus( in the region of the medial process of the calcaneus) at the place where the muscles and fascia that hold the arch of the foot attach to it, such a calcaneal spur is called the plantar spine. More rarely, the spur is located on the posterior surface of the calcaneus( in the region of the posterior hillock of the calcaneus) at the attachment point of the Achilles tendon - the posterior calcaneal spur.
Spur consists of newly formed bone tissue with signs of chronic inflammation. In soft tissues, a mucous bag is often formed over the bone spur.
Heel spurs are quite common. They are found in 26.4% of people aged 40-44 years, and in the age group 70 years and older - in 88.5%.
Schematic illustration of plantar spinal spine
Reasons for calcaneal spur
1. Chronic trauma is considered one of the most frequent causes of heel spurs, which is observed in athletes, runners, dancers.2. Flattening, in which there is an increased tension of the plantar aponeurosis. This leads to the fact that when the foot is rolled during walking, the attachment site of the plantar aponeurosis in the calcaneal bone is constantly damaged. In this place, the inflammatory process develops with the gradual formation of the bony protuberance.3. Excessive burden on the legs associated with the profession.4. Rapid weight gain for obesity.5. Wearing uncomfortable, tight shoes.6. Contusion of the calcaneus, marginal fractures in the region of the calcaneus calcaneus.7. Recurrent bursitis( inflammation of the joint bag) Achilles tendon( for example, in athletes with frequent traumatism of this area).
Symptoms of calcaneal spur
Patients with plantar spur complain of acute burning pains in the calcaneal region while resting on it, which they compare with the sensation of "nail in the heel".Pain can spread throughout the calcaneal region. Sometimes they can appear suddenly and have an acute nature, and in some cases develop gradually. The dimensions of the spur do not affect the intensity of the pain caused by it, since the painful sensations are primarily caused by inflammatory changes in the soft tissues( subclavian bursitis, Achilles tendon bursitis, periostitis( periostitis)), sometimes involving nearby small nerve branches. Because of the development of intense pain, patients try to unload the heel, for which they walk on their toes or on the outer edge of the foot( "they will clumsy" the foot), and with bilateral damage the gait acquires a "sliding" character, patients resort to using a cane or even crutches.
Diagnosis of the spur of the calcaneal
In some cases, large-sized spurs of a pointed form do not manifest themselves clinically and are detected accidentally by radiography.
At inspection of visible inflammatory changes at a plantar heel spur, as a rule, it is not defined. It is not probed under a thick layer of soft tissue, while only soreness is detected when pressing on the heel from the plantar side. With a back calcaneal spur, there is sometimes swelling and omozolelost of the skin at the place of attachment to the heel bone of the Achilles tendon.
For the purpose of clarifying the diagnosis, X-ray and ultrasound examinations are performed. Radiographs of the foot in the lateral projection is determined by the formation of additional bone density as a stud or beak in the plantar surface of the tuberosity of the calcaneus( with plantar spur) or at the point of attachment of the Achilles tendon( at the rear spur).In the ultrasound examination of the soft tissues of the foot with the plantar spur, signs of plantar( plantar) fasciitis are revealed.
Lateral radiograph of the calcaneus patients with plantar heel spur( marked by the red arrow)
Treatment of heel spurs
in the treatment of heel spurs are used, mainly conservative methods aimed at removing inflammatory changes in the surrounding soft tissues. These methods include wearing special orthopedic insoles and special orthopedic shoes to unload the heel area. Individual orthopedic insoles have a recess and a soft lining in the heel area, and the orthopedic footwear has a groove in the heel( with a plantar spur) or in the back( at the back).Patients themselves can make a soft foam from the foam rubber, making a hole in its center or a hole.
Apply warm baths with the addition of sea salt, prescribe a massage of the muscles of the feet and shins and therapeutic gymnastics. From fizioprocedures ozokerite or prafinovye applications are used, electrophoresis of novocaine, phonophoresis of hydrocortisone. In the case of pronounced inflammation, a bed rest is prescribed with resting rest to the foot or by imposing an immobilizing gypsum longus for up to 10-14 days. It is possible to use laser therapy, magnetotherapy and X-ray therapy. Sometimes the puncture of the subclavian bursa and the introduction of glucocorticosteroids into it in strictly sterile conditions are also used.
When conservative therapy is ineffective, it is sometimes necessary to resort to surgery, which consists in removing the heel spur together with the underlying bone site, the operation is performed under intraosseous anesthesia. When the plantar calcaneal spur horseshoe incision is made along the lower edge of the heel bone, the flap of skin with subcutaneous fat to be turned away in the direction of the fingers, and then cut off the muscle and plantar aponeurosis, which is attached to the calcaneal tuberosity. The spur is removed along with the underlying bone plate, at the same time the subcutaneous calcaneal bag and part of the fatty tissue are excised. The wound is sewn layer by layer. A pressure bandage is applied, immobilization is carried out with gypsum lint for 4 weeks. After removal of the longa, orthopedic insoles are prescribed.
Prognosis with spur
Prognosis for calcaneal spur, provided timely and rational treatment is favorable.
Prevention of calcaneal spur
In order to prevent the development of calcaneal spurs, it is advisable to avoid excessive loads on the feet, especially to people suffering from flat feet or prone to developing it.
Doctor surgeon Kletkin ME