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Many people suffer with heel spurs and the usual medical approach to this problem is to treat the heel.  The problem is, most heel spurs are not caused by problems in the heel itself, that’s just where the mechanical stress ends up.

 Yes, a cortisone injection into the area of a heel spur may sometimes decrease the pain, but all the cortisone is doing is decreasing inflammation - it’s not healing, er, fixing the heel.

So, what causes a heel spur to develop?  In most cases, it’s excessive tension on the soft tissue attachments at the bottom of the heel bone.  This excessive tension pulls on the bone, and the body’s response is to add bone to the area to reinforce it.  Over time, a spur grows. 

Have you, or someone you know, ever had a heel spur surgically removed, only to have another one grow back in the same place within a few years.  This is a common occurrence, because the surgery does not address the soft tissue tension.  The ONLY long term solution for heel spurs in most cases is to address the soft tissue tension directly.

 So, how do you do that?  You have to either massage or stretch (or both) the muscles in the calf and foot.  A simple calf stretch can be done by grabbing a towel at both ends, looping the middle around the ball of your foot, and pulling the front of your foot towards your body (you should feel a pull in the calf when you do this).  This will also stretch the foot to an extent.  Massage can be done by just gripping behind the lower leg and massaging the muscles with your fingers.  Massaging the feet can be done the same way, or by rolling your foot over a golf ball or other firm, round object.

Frequency is the key to getting good results.  When I recommend such treatments to my patients who have heel spurs, most will start out doing them regularly, but many stop doing them after a few days or may only do them for 30 seconds or so at a time and then complain that they didn’t work.  In those cases, I will proceed to do an intensive (some have used the term “painful”) stretching and massage treatment on them for one or two sessions and this usually fixes the problem.  Basically, you can do it the easy way or the hard way.  If you want to alleviate your own heel spurs without the expense and perhaps physical pain of a professional treatment, I recommend using a combination of stretching and massage as just described at least once a day for at least a few weeks.  In most cases, even once the heel spur is feeling better, it will be necessary to stretch at least a couple of times per week to keep the symptoms from coming back.

 Getting back to the title of today’s post, the interesting thing is that the pain that’s blamed on a heel spur can change drastically with these self-treatment measures within a few days or weeks - even though there’s usually no visible change in the spur itself on X-rays in that short of a period of time (over several months or years, the spur may gradually go away if the soft tissue tension that caused it is prevented from returning).  So, if the spur is still there, but the pain is gone, what was causing the pain?  I think you’d have to agree that it was the soft tissue. 

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