SPRINGFIELD, Pa. – Getting out of bed on those hazy, lazy days of summer can be a real pain in the neck for anyone. But for many people, it can be a pain in the foot, too. Aching bone spurs that act up first thing in the morning send hundreds of thousands of Americans to their podiatrists each year for relief of their symptoms.
Bone spurs can occur throughout the body, but are commonly found in the foot. They form in response to stress from the pulling of ligaments or from arthritic conditions in the joints over a prolonged period of time, when the body tries to repair itself by building extra bone in response to excessive pressure, rubbing or stress.
“There are basically two types of bone spurs that can occur in the foot,” says David Samuel, D.P.M., a podiatrist at Springfield Hospital. “Spurs that occur in the toes, midfoot, or ankle joints are often related to arthritic or post-traumatic conditions and become uncomfortable because the spur rubs on the joint or shoe. Heel spurs, on the bottom surface of the heel, occur with the repetitive chronic stretching of the plantar fascia, a long ligament that connects the heel bone to the toes and supports the arch of the foot. As it becomes strained, the plantar fascia can become inflamed. The spur forms over years of tension on the heel attachment of fascia. The fallacy is that heel spurs hurt. The heel spurs themselves do not cause pain—it’s the inflammation of the plantar fascia (a condition known as plantar fasciitis) that hurts.”
Many people who have heel spurs are unaware of them. Instead, the condition is discovered when the foot or heel is X-rayed for an unrelated condition or for a preliminary plantar fasciits workup. However, arthritic spurs that are rubbing on tissues, muscles or tendons, or interfering with joint motion, can break down that tissue over time and cause swelling, pain and tearing. In the case of heel spurs, while the spurs themselves cause no pain, the associated plantar fasciitis is extremely uncomfortable.
“The characteristic symptom of plantar fasciitis is pain that occurs after a period of rest, such as first thing in the morning,” says Bruce G. Greenfield, D.P.M., chief of the Section of Podiatry at Delaware County Memorial Hospital. “After you walk around for a bit, the pain eases up. The pain can return later after you’ve been sitting down or otherwise resting your foot for a while.”
There are a number of treatment options for heel spurs and plantar fasciitis, ranging from conservative to aggressive. Most podiatrists recommend first using conservative treatments, such as over-the-counter anti-inflammatory medications (such as Advil or Aleve) or simple stretching exercises.
“One of the most common and effective treatments for plantar fasciitis is a device called an orthotic, which can be inserted into most types of shoes and serves to support the arch of the foot and reduce pressure on the plantar fascia,” says William Urbas, D.P.M., chief of the Division of Podiatry at Crozer-Chester Medical Center. “Orthotics can be purchased over-the-counter, or they can be custom-made to fit your foot by a podiatrist. Either way, they serve to correct the arch of the foot and improve your foot health, much in the same way that eyeglasses can improve your vision.”
Should conservative measures fail, podiatrists can recommend everything from regular injections of corticosteroids to reduce inflammation to surgery to release tension in the plantar fascia. Such methods are often used as a last resort.
Bone spurs in other areas of the foot rarely require treatment, unless they are causing symptoms. Treatment may include weight loss to take some pressure off the joints, resting the joint, applying ice to the joint at regular intervals, and taking anti-inflammatory medications. Padding or shoe inserts can help reduce pain from the spur rubbing against tissue or muscle, and corticosteroid injections can reduce inflammation in affected areas. Again, surgery to remove the spur is considered a last resort.
Unfortunately, most people with bone spurs and plantar fasciitis are predisposed by birth to having them. A foot structure that puts pressure on the plantar fascia is commonly blamed for heel spurs and plantar fasciitis.
“There are a few ways to reduce your risk of developing heel spurs and plantar fasciitis,” says Frank Adamo, D.P.M., a podiatrist who practices at Taylor Hospital. “If you are on your feet for a good portion of the day, or if you wear footwear like steel-toed boots, take a break every few hours to rest your feet or to do some simple stretching exercises to relax the plantar fascia. Also, make sure you’re wearing well-fitting, comfortable shoes, and use an orthotic or insert if necessary. Don’t go barefoot—it can flatten the arch of the foot and strain the plantar fascia.”
In addition, if you experience foot pain that lasts longer than 2 to 4 weeks, see your podiatrist. Heel pain can mask other issues that can cause long-term damage if not treated.
To find a Crozer-Keystone podiatrist who’s right for you, call 1-800-CK-HEALTH (1-800-254-3258).