Calcaneal spurs are bone excrescences that form in the calcaneus (heel bone) that may be due to excessive bone traction through the tendons or fascia (the connective tissue attached to the bone). A spur of the calcaneus can cause the foot pain in the lower part of the heel. Flat feet (an abnormal flattening of the sole and arch of the foot) and disorders in which the contraction of the Achilles’ tendon is permanent may excessively tighten the fascia, increasing the risk of calcaneal spurs. This symptom can prevent if you use shoes or Insoles for Fallen arches. The calcaneal spurs usually cause pain as they develop, especially when the individual walks. Briefly, the calcaneal spur is a “fight” of forces between the musculature of the sole and the muscles of the calf, both having to be necessarily in spasm.
Sometimes a bag containing liquid (bursa) develops under the spur and ignites. Generally, in this condition, called lower calcaneus bursitis, the pain becomes the throbbing type, and this can occur even in the absence of a spur. Sometimes the foot adapts to the spur such that the pain diminishes as the spur grows. On the other hand, a painless spur can become painful after a minor injury to the area as it can occur, for example, while playing a sport.
Commonly, calcaneal spurs can be diagnosed during the physical examination. When there is a spur, applying pressure to the center of the heel causes pain. Radiographs can be performed to confirm the diagnosis, but they may not detect newly formed spurs. The treatment aims at pain relief. Physical therapy has a fundamental role in the treatment and cure of this spur. The goals of the treatment areto relievethe pain and decrease the tension of the calf muscles and plantar fascia. Once this myofascial release, it will eliminate the cause. It is known that the bone has its complete remodeling in 5 years, being preserved this balance of the forces of these muscles, it is possible in 5 years not to “appear” more in the image examination the spur.
An easy recipe to relieve plantar fascia tension is foot scaling.
Most painful heel spurs heal without the need for surgery. Sputum removal surgery should only be performed when pain interferes with walking. However, the results of the surgery are unpredictable. Occasionally, the pain persists after surgery.
Plantar fasciitis or plantar fasciitis refers to a plantar pain in the plantar fascia. It happens from inflammation caused by repetitive microtrauma in the origin of the medial tuberosity of the calcaneus. The tensile forces during the support lead to the inflammatory process, which results in fibrosis and degeneration of the fascial fibers that originate in the bone. Plantar fasciitis appears more frequently in obese individuals. Excessive pronation of the foot is more likely in the development of this disease, due to the increase of the force resulting in the aponeurosis, as a consequence of the arch lengthening and extension of the fingers.
Plantar fasciitis is not the same as the spur of the calcaneus.
When the lesion near the bone occurs, it may try to heal itself by producing new bone. This results in the development of a calcaneal spur. Without the spur, the condition is called plantar fasciitis, only the muscle injury. The calcaneal spur is a spur-shaped reactive bone formation (bone spike), located on the plantar surface of the calcaneus (foot bone). People with this pathology have pain in the plantar region under the calcaneum.
The fascia is a tight band of dense connective tissue that attaches from the calcaneus to the base of the toes (beam for the maintenance of the medial longitudinal arch). The Achilles tendon also attaches to the calcaneus. If the tendon is very tense, there is redistribution along the fascia. If you feel unstable during walk or cycle or your foot flattens or, the arch flexes by pulling the plantar fasciitis. Too much tension can tear it apart. This will possibly result in foot pain and swelling. When this happens close to the bone, it can try to heal or recover itself by producing new bone. This lead to the increase of a calcaneal spur. The condition without the spur is called plantar fasciitis. The fascia retains muscles and tendons in the sole and fingers, reduces compression of the arteries and plantar and digital nerves, and perhaps aids venous return. In the support triangles, there is the fatty cushion responsible for the decrease in the pressure (elastic damper). Parts of the deep fascia, inferior to the plantar structures, are the plantar aponeurosis.
The treatment indicated for the two injuries would conjugate myofascial release, relief of the agonic framework and use of postural pills to maintain the gains acquired during the physiotherapy sessions.