Cause and origin

The cause of heel spur development is based on increased pressure and tensile stress on the tendon attachments on the heel bone body. This stimulus triggers conversion processes in the tendon fibers, which ultimately leads to a spur-like, footward-facing new bone formation. The heel spur can lead to an inflammatory reaction of the surrounding tissue due to its pressure load. Triggering factors for the development of a heel spur are

Age
Overweight (Adiposity)
Bad footwear
Overloads (occupation)
Foot malformations with elongation of the longitudinal arch of the foot (frequently: buckling and flat foot, sometimes also splayfoot).

SymptomsComplaints

Patients with a painful (symptomatic) lower heel spur report stress-related pain in the heel area. Depending on the stage of the disease, the pain may occur only after prolonged stress or be permanent. A typical symptom of the heel spur is the pain under the heel in the morning, which initially improves during the course of the day.

The pain character is usually described as stabbing, occasionally also as burning. A pain radiation into the foot as well as into the lower leg is possible. To relieve the painful area, patients sometimes walk over the outside of the foot.

The upper heel spur also causes stress-related pain in the area of the Achilles tendon insertion and especially when driving a car. Both forms of heel spur can lead to a significant reduction in the level of activity. The patient’s medical history (anamnesis) provides the decisive indication of the underlying disease of the heel spur, since the pain is usually indicated in very specific points.

Somewhat on the inside of the heel on the sole of the foot, the described pain can be provoked by pressure. The suspected diagnosis is usually confirmed by an x-ray of the lateral heel bone (calcaneus). However, there is also the possibility that the classic heel spur complaints only herald the onset of spur formation and that the X-ray image is initially inconspicuous.

An MRI of the foot and sonography are not necessary for the diagnosis of heel spur disease and are more important in the exclusion of other diseases.However, differential diagnoses are of little importance because of the clear symptoms of the disease. Especially long-distance runners are often affected by a heel spur. This can be caused by the high strain on the heel.

But runners who do not run very intensively can also be affected. This mainly affects people of advanced age, as the fat pad under the heel disappears with age and thus no longer has a shock-absorbing effect. If the first symptoms of a heel spur occur while jogging, care should be taken to avoid jogging in the acute stage until the pain subsides.

In the long term, care should be taken to wear shoes that provide as much cushioning as possible. When buying running shoes, care should be taken to ensure that they may have special heel padding. People who belong to the risk group of heel spurs should already take preventive measures when buying their footwear to ensure that this padding and cushioning is present.

The symptoms of heel spurs usually improve for joggers when they run on soft ground. If you experience pain when jogging on asphalt, it can be much less severe or non-existent when running on forest floor. Before running, sufficient stretching exercises should be done to warm up. This applies especially to runners with a heel spur. Especially the calf muscles should be stretched extensively.