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Heel Pain – Could it be a Heel Spur

With each step we take, we exert a force of up to 3 times our body weight on our feet. This has a large impact on the heel and can be a reason for that nagging pain. The plantar fascia attaches to the heel bone and is the culprit in 73% of case of plantar heel pain.1 Yet, one myth that continues to be perpetuated is that a heel spur is the cause of all heel pain, 100% of the time. Yes, heel spurs can be the cause. But they aren’t always.

Heel Spur X-Ray

How does a heel spur develop?
Of the 18 muscles that originate and insert on the foot, 3 arise from the middle tuberosity of the calcaneus (heel bone). Wolfe’s law states that bones will adapt to the loads or pressures placed on them. As the muscles that attach to the heel bone pull, new bone is formed in response to the tension. This new bone formation, or osteophyte, forms on the heel, at the place where the middle muscle in the group of three that attach to the heel (the flexor digitorum brevis) pulls against the heel. Although the bone forms near the insertion of the plantar fascia, it is actually not that ligament, but the belly of the flexor digitorum brevis that causes the heel spur. This proximity to the plantar fascia is why many confuse heel spurs with plantar fasciitis, or inflammation of the plantar fascia ligament

Who should treat your plantar heel pain?
Podiatrists are the most experienced and qualified physicians to diagnose and treat heel pain. Acute and chronic heel pain makes up 20-25% of some podiatrists’ practice. They know their stuff. Heel pain can be caused by heel spurs, or something else. And, some heel spurs don’t even cause pain. If you want the best treatment for your feet, see a foot doctor.

1. Fishco W, Goecker R, Schwartz R. The instep plantar fasciotomy for chronic plantar
fasciitis. J Am Podiatr Med Assoc 90:66–69, 2000
2. McCarthy DJ, Gorecki GE. The anatomical basis of inferior calcaneal lesions.J Am Podiatry Assoc. 1979;69:527
3. Foreman MW, Green MA. The role of intrinsic musculature in the formation of inferior calcaneal exostoses. Clin Podiatr Med Surg 1990;7:217-223

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