Heel Spurs

Celebrity Q and A'sHeel Spurs. What can we do about them? Is massage a good thing?
Pam 11/30/99

Heel Spurs - This is a common problem seen in all podiatrists offices at the present time. A little background: Rather than calling this condition a "Heel Spur" it should be called a "Heel Pain Syndrome" because it arises from a number of different factors. The heel spur is not the cause of the problem but just a part of a larger more complex foot problem. The spur (only seen in approximately 50% of patients who have heel pain) is not the cause of the pain. It is the soft tissues (the plantar fascia) that insert into the heel bone along with the outer soft tissue covering (the periostium) of the bone that become inflamed and begin to hurt. The reason this happens in 93% of the patients with heel pain is a mechanical one. How the pressures are transferred from the heel out through the toes is the cause. This causes extra pressure and stress on the soft tissue around the heel and thus the pain. The reason it hurts most during the first few steps when one first gets up in the morning or during the night is that without weight on it the area because of the inflammation becomes more swollen thus the pressure on the nerve endings is much more and causes the extra pain. After a few steps the extra fluid is squeezed out and less pressure causes less pain, but after being on it all day long it becomes more inflamed and thus hurts more!

What can the Nail Professional do for a client with this condition? They should recommend a supportive athletic shoe as the support will take the stress of the plantar fascia where it attaches into the heel bone. Over the counter arch supports for other shoes will also give some relief. One must also recommend that the client wear these supportive shoes in the evenings as if the do not they loose all that may have been gained during the day. Massage may make the area feel better but is not the cure. There is no quick fix!!!! I tell all my patients that! If the recommended supportive shoes and devices do not give enough relief then refer the client on to the podiatrist for possible cortisone injections (these also are not the "cure") to help get through the acute stages of this condition. In many cases a true biomechanical orthotic made from a cast of the patients feet will be necessary.

Dr. Oscar Mix


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