Orthopedist A heel spur causes severe and stinging pain

There is nothing to see from the outside, but it can still cause infernal pain: if the foot stings and hurts when it hits, there may be a heel spur. The earlier a treatment is initiated, the better the chances of recovery. We show what the causes are and what therapeutic measures help.

Massive pain at the heel as it occurs, with no apparent cause, is often due to a heel spur. The affected persons are thereby considerably limited in their everyday life for months. The causes of the development of heel spurs and how they can be treated, explained the chief physician of the Department of Foot and Ankle Surgery in Bad Neustadt, Renée Fuhrmann.

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The heel spur in this country is a veritable common disease, with those affected often suffer for months in pain. From the outside, this was not visible, but under stress, if necessary, stabbing pain would show. Cause is the formation of an additional small bone, the ossification itself often occur and not necessarily lead to discomfort. If, however, in the following episode a plantar fasciitis, ie an inflammation of the plantar tendon on the sole of the foot, is at worst severe pain at every step. In total, about ten percent of Germans would suffer heel pain at least once during their lifetime.

Two forms of heel spur
Basically, the heel spur, according to Renée Fuhrmann "very common" and about every third person show this additional ossification. In people over the age of 50, the incidence continues to increase. Depending on the localization, two different forms of heel spur are distinguished. Haglund exostosis (also Haglund syndrome), which is characterized by a bone outgrowth on the upper approach of the Achilles tendon and the much more frequent osseous outgrowth under the foot, which is referred to as plantar heel spur or Kalkanueussporn. The pain in a heel spur are increasingly observed in the morning after getting up, which initially seems illogical, since the feet were not charged in the hours before. According to Renée Fuhrmann, however, the feet are in a flexed position during sleep, and in the morning the calf muscles are stretched at the first load, causing pain in the case of an inflammation of the plantar tendon.

Shoes with high heels and overweight are risk factors
Not infrequently, the heel spur remains undetected for a long time, especially when no symptoms are reported. Even "if he can be seen on the X-ray, that does not mean that you have to have pain," Renée Fuhrmann is quoted by the "dpa". In addition, the disease is usually already long, if the heel spur in the X-ray is recognizable. "It is a sign that there has been an inflammatory change in the muscle-tendon approach," said the head physician. Particularly at risk are women, who are significantly more ill than men. In addition, patients with rheumatism would disproportionately often fall ill and also in patients with sink or flat foot is an increased risk of disease detectable. Moreover, obesity is a risk factor and heel spur can also be promoted by the increased wearing of high heel shoes. The high heels caused a shortening of the calf muscles and thus increase the risk of plantar fasciitis, so Fuhrmann.

Physiotherapy promises relief
According to the expert "stretching therapy of the calf muscles" is the best option against the heel pain. This can be done, for example, by appropriate exercises with a physiotherapist. Here, the calf muscles are trained and the stretching exercises usually show after a short time an improvement. However, the exercises must continue until the patients are symptom-free, which may take several months. In addition, many orthopedic surgeons would not issue a prescription for this. Alternatively, those affected could learn useful exercises from the physiotherapist at their own expense. If all treatment attempts do not help, according to the expert, surgery remains the last option in which the tendons are detached from the bone. However, this is only rarely necessary and only a scenario for the extreme case. Injections with cortisone, which are to help against the inflammation, however, would be used more frequently. Also, electrotherapy forms a possibility of treatment.

Healing takes months
To protect the feet against the pressure, orthopedic surgeons, according to the expert, are often prescribed shoe inserts. These deposits with so-called softspots would often be perceived by the patient as very pleasant and were practically like wellness for the foot. However, this brings little for the cure, as such a deposit has no effect on the disease. If a plantar fasciitis has developed, according to the expert anyway a longer healing period is to be planned. Because they do not leave after four weeks. You have to calculate in months, "said Fuhrmann to the" dpa ". In her opinion, the cure needs a realistic half to nine months. However, plantar fasciitis also shows a self-healing tendency. The symptoms would usually resolve and it is "very unlikely that the pain will remain chronic."

Special protection not required
If the pain permits it, those affected do not need special care in case of plantar fasciitis, but can do all the usual activities, Fuhrmann continues. Even sports restrictions are usually not required. Even jogging, for example, remains possible. In particular, exercise, which is good for the calf muscles, could even have a positive effect here. If the heel pain persists even after months, it may be the cause of a nerve compression syndrome, which is a relatively specific symptom and not every orthopedist would immediately recognize it. In this case, according to the expert, an operation would be necessary. (Fp)