What Is A Heel Spur?
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Heel spurs usually form under the base of the foot or the back of the heel bone. Spurs that develop underneath the foot may visibly protrude through the skin. In addition, plantar fasciitis as well as heel spurs may eventually lead to chronic pain that persists for three or more months, especially if the sides and base of the heel bone have been affected. A large heel spur can affect movement and prevent an individual from walking or even standing properly. If a heel spur begins to protrude excessively, then surgery usually becomes necessary.
Causes Of Heel SpursA heel spur usually develops as a result of wear and tear over time, which leads to the degeneration of connective tissue called fascia. Standing for prolonged periods and wearing shoes that do not provide the right type of arch support can also lead to connective tissue damage in the heel. The body attempts to repair the damaged tissue by delivering calcium to the affected region, but sometimes too much calcium begins to accumulate and this results in painful plantar fasciitis.
Diseases such as arthritis may also lead to chronic inflammation in the tissue surrounding the heel and over time this can lead to the accumulation of calcium deposits. Ankylosing spondylitis, for example, is one particular form of arthritis that frequently develops along with heel spurs. This condition can damage bones all over the body and even lead to the fusion of spinal vertebrae.
Additional factors that increase the risk of developing heel spurs include a high body mass index (BMI), regular vigorous activity, and intensive training routines or sports. Factors such as these are believed to increase the incidence of repetitive stress injuries that are associated with the formation of heel spurs. When a heel spur forms, extremely sharp pain along with the feeling that a part of the heel is trying to burst through the skin usually occurs. If left untreated, an individual may eventually begin to struggle to perform simple activities such as walking.
Treatments For Heel SpursNerves located in the lower region of the back, called sacral nerves, are responsible for the transmission of pain signals from the foot to the brain. Nerves in that particular region of the back can be targeted in order to treat heel spur pain that has become chronic.
A spinal nerve block is a non-invasive procedure that entails locating and blocking the nerve roots that are transmitting the heel pain signals. The problematic nerves are located through the use of imaging devices such as an X-ray or magnetic resonance imaging (MRI). After the responsible nerves have been correctly identified, a catheter and needle are inserted into the back next to the targeted nerves and medication that blocks the pain is administered. A steroid is usually injected in order to reduce inflammation, along with lidocaine, which is an anesthetic that blocks pain signal transmission.
Nerve blocks are associated with risks, including adverse events that may be caused by drug interactions, especially due to their signal blocking potential. Common side effects of anesthetic injections include possible nerve damage, numbness, a loss of sensation, and discomfort at the injection site. Additional complications may develop if the medication is injected into the wrong area or if a blood vessel is accidentally injected. Steroid injections may cause side effects such as an increased incidence of arthritis, stomach ulcers, and immune system deficiencies, as well as weight gain. Some individuals also experience headaches after undergoing a nerve block, but this is usually temporary.
Another treatment method that may be performed to treat heel spurs is called radiofrequency ablation. This procedure utilizes radio waves that produce heat that can be directly administered to the targeted nerves. Heat is delivered to the nerves through electrical pulses that temporarily impair nerve function or completely destroy nerve tissue.
Before the treatment begins, a microelectrode is placed into the lower back near the sacral nerves. A mild electrical pulse is delivered during the placement of the electrode. This initial pulse produces tingling in the body that will help a physician assess whether the electrical stimulation is reaching the appropriate nerves. It is important that motor nerves are not affected by the ablation procedure as this may lead to motor problems.
After the correct placement of the electrode has been confirmed, a stronger electrical current is administered to the nerves that are contributing to the heel pain through a continuous approach or a pulsed approach. The continuous method entails raising the temperature gradually to approximately 122°F. The targeted nerves are exposed to this temperature for 90 seconds, which is the amount of time that it usually takes for the heat to block the transmission of the pain signals. The pulsed approach involves exposing the targeted nerves to a lower temperature of 104°F for a brief 20 millisecond period followed by 480 milliseconds in which the nerves can cool down. The occurrence of side effects and tissue damage is lower when the pulsed approach is applied.
ConclusionHeel spurs refer to the abnormal accumulation of calcium deposits on the heel of the foot. Vigorous, repetitive movements often result in the formation of heel spurs, but inflammatory diseases (e.g., arthritis) may also increase the occurrence of painful heel spurs. Treatments that have proven to be effective for heel spurs include injections that contain a combination of steroids and anesthesia as well as radiofrequency ablation. However, a bone spur that begins to protrude excessively may need to be removed through surgery.
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