The heel is the largest of the 26 bones in the human foot and absorbs the largest amount of shock and pressure. A heel spur develops as an abnormal growth of the heel bone. The plantar fascia is a band of fibrous tissue which is located along the bottom surface of the foot running from the heel to the forefoot. When the plantar fascia pulls away from the heel area calcium deposits form and a heel spur or bony protrusion develops. Stretching of the plantar fascia is usually the result of over-pronation but people with unusually high arches can also develop heel spurs. Women have a higher incidence of heel spurs due to their choice of footwear worn on a regular basis.

Heel spurs can cause extreme pain particularly when standing and walking and is at its worst when taking the first steps in the morning whilst getting out of bed. Some patients report a sharp stabbing pain at the bottom or front of the heel bone. Generally the pain will subside to a dull ache whilst you carry on with your normal activities. Unfortunately the pain will come back when rising from being seated or lying down for a long period of time.

Heel spurs are more likely to occur if:

• you are overweight or pregnant;
• you have tight calf muscles;
• you walk or stand on hard surfaces for long periods of time;
• you suffer from over-pronation.

The most effective treatment method for heel spurs is to treat the cause of the problem by correcting abnormal foot biomechanics with an orthotic insole. Custom orthotics can help to relieve the tension on the Plantar Fascia therefore relieving the pain of a heel spur. For added relief a shock absorbing heel pad may be incorporated into the orthotics which will reduce the impact on the heel when walking.

In order to diagnose the problem and prescribe the correct type of orthotics the Podiatrist may need to carry out a Functional (Biomechanical) Assessment. A Functional Assessment includes a gait analysis to look at the way that you walk and a pressure plate analysis to measure the forces that are running through your feet when you step on the ground. From the results of the analysis, the Podiatrist can manufacture a pair of custom orthotics specifically for your foot and its biomechanics. Stretching exercises may also be prescribed by the Podiatrist in order to stretch the tissue throughout the foot and calf. This can help to reduce strain and promote healing in the area. In most cases, heel spurs can be treated using simple methods.