Podiatry/Heel Spur


My husband has a heel spur and plantar faciaitis. The heel spur showed up on an X ray when first diagnosed. It flared up so badly recently he saw his doctor again. Doctor said surgery is usually not performed  and he got a cortisone shot.
He was told it might take a while to improve, and he might need another shot.
In two weeks it has not improved at all, in fact he says it is a bit worse. He has new arch support soles, does foot stretches-nothing helps. The pain centres right on the spot the heel spur is. Should he wait it out, or insist on surgery to have the hel spur removed?

Hi, Sue,

Sorry to hear that your husband is suffering.  Plantar fasciitis can be incredibly painful, and I hope his doctor is able to help him find relief.  It may be surprising to know that the heel spurs themselves have little to do with his pain.  Heel spurs are not always present with plantar fasciitis, and some people have spurs without any pain.  It's the inflammation in and around the band of connective tissue that attaches there, not the bone itself, that causes the pain.

I don't recommend jumping into surgery until other treatment options have been exhausted.  A physician can give up to three cortisone injections in that area, and some patients don't respond to the first one (or might improve, but only for a day or two) but find good results with the second or third.  Has his doctor put him on an anti-inflammatory medication, such as ibuprofen, naproxen, or meloxicam?  Sometimes I'll have my patients take those pills for a couple of weeks to try to calm things down.  I also recommend that they take a bottle of water, put it in the freezer, and once it's frozen start rolling their foot over it when they come home from work.  It acts as an ice massage, or what I like to call a "two-for-one special," as ice and massage can provide some relief.  Definitely continue with the stretches and the inserts.  The inserts are firm (sort of like a hard plastic), right?  Make sure he wears them in all and any shoes he wears, switching them into different pairs if he wears dress shoes to work and sneakers after he gets home.  Also, walking barefoot should be avoided.

I hope this helps.  As I said, I don't recommend surgery at this time, and even if it comes to that, the doctor probably won't remove the spurs themselves.  We rarely do that in the US.  Instead, the focus is on releasing some of the connective tissue (part of the plantar fascia) to provide some relief.  But surgery also has the risk of creating other problems such as infection, excessive scar tissue, and nerve entrapment.  That's why we try conservative treatment first.

Best of luck to you and especially your husband.

Wishing you health, happiness, and peace,
Dr. Bodart


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Dr. Amy Bodart


Questions relating to podiatry: medicine and surgery of the foot, ankle, and distal leg


Associate at Advanced Podiatry, 2919 W Swann Ave, Tampa, FL 33609 www.TheTampaPodiatrist.com


Graduated from the Ohio College of Podiatric Medicine in Cleveland, OH 3-year forefoot and rearfoot residency training from Kendall Regional Medical Center in Miami, FL

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