The plantar calcaneal spur has been classically described as a bone outgrowth localised just anterior to the medial tuberosity of the calcaneus. 4 This can not often be palpated clinically, but only seen radiologically as shown in the x-ray on the right above. What is clear is that there is huge variability in the location of heel spur formation, and if we cannot unequivocally state that the spur is within the fascia (which we cannot) then the validity of its link with ‘plantar fasciitis’ is questionable. Hypermobility, (excessive internal motion) of the foot can induce future or coexisting problems involving the knee, hip, sacroiliac joint or the low back region. Plantar Fasciitis is inflammation of the band of tissue (the fascia) that extends from the heel to the toes. The Fascia becomes irritated and inflamed and this results in the pain in the heel of the foot. Some patients describe this pain as worse when they get up after sleeping or sitting for long periods of time and also when standing stationary for long periods of time. The plantar fascia is a tough, fibrous band of connective tissue that runs from the heel bone to the ball of the foot. It plays an vital part in the way the foot is intended to operate whilst walking and running. Plantar fasciitis is usually controlled with conservative treatment. Following control of the pain and inflammation an orthotic (a custom made shoe insert) will be used to stabilize your foot and prevent a recurrence. Over 98% of the time heel spurs and plantar fasciitis can be controlled by this treatment and surgery can be avoided. The orthotic prevents excess pronation and prevents lengthening of the plantar fascia and continued tearing of the fascia. Usually a slight heel lift and a firm shank in the shoe will also help to reduce the severity of this problem. Once these have been tried if the pain is still extreme there may be further measures needed to give you comfort from your Plantar Fasciitis. The doctor may decide a shoe modification is necessary and have orthotics made that will be worn inside your shoes to relieve this condition. The physician may also prescribe night splints, which help to extend and stretch the planar fascia while you are sleeping. This helps to reduce the pain in the morning upon rising. Also a removable walking cast can be used to keep the foot immobile for a few weeks. Orthopedic shoes are specially designed footwear for people who suffer with foot problems. Orthopedics offer a rubber sole, which cushions the heel and adds comfort to those who suffer from heel spurs. Another simple way to help the pain of heel spurs is to elevate the ankle to diminish the pain. When elevating the ankle, the blood is not focused on that area of the foot and can bring some relief. When all these options have been attempted, and there is still no relief from heel spurs, or the heel spurs return, surgery can be the more dramatic and permanent way to rid patient of heel spurs. Heel spurs are abnormal protrusions coming out from the heel They are caused by an inflammation of ligaments and they can be extremely painful and disturbing. Overworking the tendons in the heel area usually leads to this condition; this is why it affects active persons or sportsmen. In severe cases heel spur can only be removed surgically, but this is nothing easy or pleasant. Most doctors only recommend surgery if nothing else works. There are a couple of home remedies on heel spur that you can try to obtain relief and, although some of them might take a while before becoming effective, they are worth the time and effort. I feel the reason for this is because footwear design is towards softer materials, which lack support. People are carrying more weight on their feet (overweight or obese) and most do not get enough of the right exercises. Plantar fascia rupture – When the plantar fascia ruptures you will notice a fairly noticeable drop in your arch on that side with the over rolling of the foot in pronation Then we can determine better when the spur started to form and that sometimes leads us to what caused the spur. This is easier in an area of the neck or lower back. The treatment of heel pain/plantar fasciitis usually begins with adjustments to the shoes to try and reduce symptoms. Recently, the American Orthopedic Foot and Ankle Society proposed a series of exercises to help treat the problem. Supporting the arch with a well-fitted arch support, or orthotic may help reduce the pressure on the plantar fascia. A special type of insert into the shoe called a heel cup can reduce the pressure on the sore area and add padding to a heel that has lost some of the fat pad through degeneration. Anti-inflammatory medications are sometimes used to decrease the inflammation in the fascia and reduce pain.