Heel spur (plantar fasciitis) is a chronic pathology that negatively affects the patient's lifestyle. Excruciating pain causes bone growth - osteophyte, squeezing the surrounding soft tissues. It is a pointed spike, the size of which can reach 12 mm. The neoplasm is often imperceptible externally, but its presence can be determined simply by pressing on the heel area. In the ICD, the heel spur is represented under the code M77.3.
Development mechanism
The plantar fascia is a fibrous tissue or ligament that connects the heel bone to the metatarsal elements. It is responsible for maintaining the longitudinal arch of the foot. When walking or running, the tissues of the plantar fascia take the greatest load in the area of its attachment to the heel tubercle. Normally, this kind of microtrauma heals and recovers on its own. However, the constant impact on the fascia is often the cause of the transformation of the periosteum.
The pathology development mechanism may be related to:
- microtrauma to ligaments;
- development of aseptic inflammation in the area of injury;
- irritation at elevatedloads on the calcaneus.
In places where inflammation develops, s alts gradually accumulate, forming an osteophyte or heel spur.
Main reasons
Every year, more than 2 million people see a doctor with symptoms of plantar fasciitis. Moreover, 70-80% of them are the fair sex, whose age is barely over 40 years old. Doctors identify several reasons for the development of the pathological process. Among them:
- flat feet;
- age-related changes associated with impaired blood supply in the limbs and with a decrease in the regenerative abilities of tissues;
- pregnancy period;
- overweight;
- vascular disease of the lower extremities (diabetes, gout or rheumatoid arthritis).
For boys, heel spurs can be caused by exercising, wearing uncomfortable shoes.
Symptoms and stages of development
Osteophyte formation can be asymptomatic if the cause of its development is permanent. In this case, the pathology is detected by chance, for example, during an x-ray examination for other indications. However, most often, plantar fasciitis is characterized by a pronounced clinical picture.
The first and most important symptom is a feeling of discomfort in the heel when walking. Its appearance is due to the pressure of the bone growth on the soft tissues. The intensity of the pain syndrome depends more on the location of the growth than on the size. It will be much stronger if the osteophyte is localized nearnerve endings.
At the first stage, the pain may disappear for an indefinite time, but after that it will definitely appear. At first, discomfort occurs in the morning when a person gets out of bed and takes the first steps. Then it increases with increasing loads. In the absence of treatment, the pain syndrome remains even at rest. It becomes cramping.
The second symptom of a heel spur is a consequence of the first: the person's gait changes. When discomfort appears in the heel area, the patient tries to unload it involuntarily. Incorrect distribution of the center of gravity of the body on the foot also provokes the development of flat feet. The change in gait is especially noticeable when spurs are present on both legs at the same time.
Diagnostic Methods
If a person knows what a heel spur looks like, he has all the signs of pathology, he should immediately consult a doctor. Such diseases are treated by a surgeon, orthopedist or rheumatologist.
However, it is impossible to make an accurate diagnosis based only on the physical examination and the patient's complaints. Heel pain is often indicative of other disorders. It can be ankylosing spondylitis, osteomyelitis, gout or rheumatoid arthritis. Therefore, in addition to studying the anamnesis, the doctor should prescribe a comprehensive examination. It usually includes:
- blood tests;
- urine tests;
- Foot MRI;
- x-ray.
The last examination method is considered the mostinformative. Osteophytes are always clearly visible on x-ray.
Therapy options
How to treat a heel spur? In each case, the treatment option is selected by the doctor individually. It is worth noting that in modern practice it is customary to combine them. Traditional methods of eliminating pathology include drug and non-drug therapy. In the latter case, we are talking about laser treatment, ultrasound. In especially serious situations, surgical intervention is required. Good results give folk recipes. Let's take a closer look at what each treatment option is.
Medication use
The main medicines for heel spurs are various ointments and gels that contain non-steroidal anti-inflammatory components. These include "Diclofenac", "Butadion", indomethacin ointment. These funds are intended for external use. They have analgesic and anti-inflammatory effects. The preparations should be rubbed into the affected area 4 times a day. The duration of such treatment should be at least 2 weeks.
To eliminate the pathology, a special patch based on herbal painkillers is also used. It is glued to a dry surface of the skin, leaving for 2 days. The course of treatment is also at least 2 weeks.
In the absence of a positive effect from external agents, the doctor may recommend a blockade of the heel spur. During the procedure, the affected area is injectedinjections with glucocorticoid hormones. The blockade allows you to quickly get rid of the pain syndrome. In this case, only 2-3 procedures are enough. However, they should only be performed by a surgeon. With an incorrect dosage of the drug, complications may develop. We are talking about the strengthening of the inflammatory process, the formation of suppuration. Too frequent treatments can damage or destroy fascial tissue.
Physiotherapeutic effect
Various physiotherapy helps to reduce pain discomfort and improve blood flow in the foot:
- ultraviolet irradiation;
- electrophoresis using potassium iodide;
- magnetotherapy;
- healing baths.
Also, doctors recommend orthopedic insoles for heel spurs. They fix the foot well, while the heel itself remains in a slightly elevated position, which reduces the intensity of pain.
Shock Wave Therapy
This method has been used relatively recently, but has already proved its effectiveness in the treatment of heel spurs. Shock wave therapy contributes to the relief of inflammation in soft tissues. The set frequency of the ultrasound wave acts on the affected area, while loosening the existing s alt deposits. They are then flushed out of the body along with the bloodstream.
Small spurs are well treated with this treatment. Therefore, you should not endure pain and postpone a visit to the doctor every time. In advanced cases, this method of treatment helpsstop the progression of the disease.
Shock wave therapy for heel spurs has some contraindications. It should not be used for arrhythmias, hypotension, thrombophlebitis, oncopathologies and during pregnancy.
Using a laser
Laser treatment has the same principle of action as UVT: the laser beam eliminates inflammation, relieves pain and swelling. During the procedure, the doctor shines through the affected area from several projections with a beam with a power of 80 mW. To obtain a positive result, you must complete 2 ten-day courses, but the interval between them should be one week.
X-ray therapy help
First of all, it should be noted that the x-ray itself is not a panacea. Treatment of spurs with X-ray therapy is permissible only in combination with other methods of therapeutic intervention. This approach allows you to fight the inflammatory process and has a quick analgesic effect. However, without proper medication, treatment will be incomplete and slow.
The degree of irradiation is minimal, so X-ray therapy is recommended in courses of 5-10 procedures. Not everyone is suitable for this type of treatment. It will have to be abandoned during pregnancy, because even small doses of radiation can adversely affect the development of the fetus.
Surgery
How to treat a heel spur with traditional remedies was described a little higher. Their main goal is to stopunpleasant symptoms. Surgical intervention is aimed at getting rid of the growth itself, but it does not exclude cases of its reappearance. Therefore, it is resorted to only in especially serious situations.
The volume of the operation depends on the nature of the pathology. During the procedure, the plantar fascia is partially or completely cut, and then the spur itself and damaged tissues are removed. With a complete fasciotomy, the anatomy of the foot is disturbed. As a consequence, a change in gait is a cause of disability.
Treatment at home
With a sharp pain in the foot, you should immediately visit a doctor. What to do if the doctor is not available? In this case, you can stop unpleasant symptoms with the help of improvised means. For example, medical bile, laundry soap and even compresses with s alt help well with a heel spur.
One of the simplest home remedies is to apply a magnet to the affected area. Keep in this position as long as possible. According to patients' reviews, after 15 procedures, pain is reduced.
Medical bile, more precisely, compresses based on it, has proven itself well with a heel spur. Before starting the procedure, the legs should be steamed in a warm bath. Chamomile decoction, sea s alt or aromatic oils can be added to the water. After about 15 minutes, the feet should be wiped dry. A cotton swab is moistened in medical bile and applied to the inflammation site. It is better to wrap the leg with a layer of polyethylene, and then apply a bandage. It is important to leave such a compress overnight.
Iodine has a warming effect, so it improves blood circulation. As a result, inflammation and pain gradually subside. Doctors consider the treatment of heel spurs with iodine to be a dubious method, because it is very difficult to get rid of osteophytes with it alone. This remedy helps to soften bone formations, but to enhance the therapeutic effect, it is necessary to use variable approaches to eliminate the pathology.
Help of traditional medicine
Among folk remedies for the treatment of heel spurs, potato compresses occupy the first place. The root crop must be peeled and grated. The resulting mass should be applied to the heel, and on top - a bandage. It is necessary to keep such a compress for no more than 4 hours, and repeat it every day.
To eliminate puffiness, use ordinary laundry soap. It must be grated on a coarse grater and dissolved in water. The liquid should be whipped to a state of foam, and then lubricate the sore spot with it. This method of treatment is suitable even for pregnant women.
Propolis is a natural product, which contains many trace elements. To treat a spur, you will need to take a small piece of it and soften it. For this purpose, you can use a water bath or microwave. After softening the propolis, you need to make a pancake from it and attach it to the affected part of the foot, cover it with gauze on top. It is recommended to wear this bandage during the day.
Treatment of heel spurs with folk remedies is best done under the supervision of a physician. Moreover, one should not neglecttraditional medicine. The recipes of folk healers should be used as an addition to the main therapy.
Prevention Methods
Methods for the prevention of plantar fasciitis can be summarized under one abbreviation - he althy lifestyle. There are several ways to prevent this disease:
- weight control;
- prevention of premature aging of the articular apparatus;
- traumatic injury prevention;
- timely diagnosis and treatment of all pathologies of the musculoskeletal system.
Pregnant women are at high risk of developing plantar fasciitis. It is caused by physiological changes that occur in the body. We are talking about the softening of the ligaments during pregnancy. Therefore, women in position need to think in advance about the prevention of pathology. It comes down to daily foot massage and wearing comfortable shoes. If the disease could not be avoided, the most sparing methods of treatment (ointments and patches) are prescribed. Also, orthopedic insoles are an indispensable treatment option for heel spurs.
