Diagnosis
In general, the heel spur has a very good prognosis and in about 90 percent of patients the pain disappears again. However, the therapies must be carried out consistently, which is often a lengthy process until the patient is free of pain. Rarely do the symptoms disappear even without any therapy, but this can take several months.
In spite of this possible spontaneous healing, one should consult a physician at an early stage, because a chronification of the pain is possible, which makes the heel spur more difficult to treat. With adequate therapy, pain relief should be rapid. Painkillers such as Diclofenac or Ibuprofen help to relieve symptoms very quickly, usually within a few days.
However, painkillers are a therapeutic option that is based purely on the symptomatic level. This means that although the pain is reduced, the cause is still present and the corresponding symptoms reoccur without the painkillers. If insoles or health shoes are worn consistently, the pain should be less intense after one to two weeks.
However, complete freedom from pain is usually only achieved after a period of between six weeks and six months. If physiotherapy is used in the treatment, it takes several weeks until the desired effect is achieved, since the muscle build-up leading to pain relief requires this time for muscular remodelling processes. With shock wave therapy, several sessions are necessary until the pain is reduced.
Usually a treatment period of three weeks is required. An operation of the calcaneal spur is only rarely used, since the conservative therapy usually leads to a successful treatment. If an operation is necessary, the symptoms can only be expected to improve after the operation wound has healed, i.e. after a period of two to four weeks.
Prophylaxis
Since the defective position and the subsequent incorrect loading of the foot is the cause of the heel spur, the most effective prophylaxis is the early correction of such malpositions by an orthopedist. Excessive strain on the foot due to overweight should be avoided by weight reduction. Furthermore, shoes can prevent heel spurs by having a shock-absorbing component, thus cushioning the impact of the load on the foot.
This shock absorption is of particular importance in sports or activities that put a lot of strain on the heel, such as running. Another factor in shock absorption is a soft surface when running. Very important for the prevention of a manifest heel spur is the protection of the foot at the onset of pain symptoms either by refraining from sports activities or by switching to less heel-straining activities such as cycling or swimming. Stretching of the calf muscles before and after sport also has a prophylactic effect on the development of heel spurs.
