Medical history (history of illness) represents an important component in the diagnosis of heel spur. Family history Social history What is your occupation? Do you have to do a lot of standing or running activities in your job? Current medical history/systemic history (somatic and psychological complaints). Are you experiencing pain? If yes, when does the … Heel Spur: Medical History
Musculoskeletal system and connective tissue (M00-M99). Bursitis (bursitis). Chronic polyarthritis Coalitio talonavicularis – malformation of the navicular and calcaneal bones. Gout (arthritis urica/uric acid-related joint inflammation or tophic gout)/hyperuricemia (elevation of uric acid levels in the blood). Calcaneal cyst (cyst in the heel bone area). Bekhterev’s disease – chronic inflammatory disease of the spine, which … Heel Spur: Or something else? Differential Diagnosis
The following are the most important diseases or complications that may be co-morbid due to heel spurs: Symptoms and abnormal clinical and laboratory findings not classified elsewhere (R00-R99). Chronic pain
General measures Cool and spare. Avoid predominant activities while standing! Nicotine restriction (refrain from tobacco use). Aim for normal weight! Determination of BMI (body mass index, body mass index) or body composition by means of electrical impedance analysis. BMI ≥ 25 → participation in a medically supervised weight loss program. Conventional non-surgical therapy methods Pain … Heel Spur: Therapy
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; furthermore: Inspection (viewing). Gait pattern (fluid, limping) [stabbing pain when walking (especially in the morning after getting up); especially plantar pain just below the calcaneus; later, pain independent of weight-bearing] Body or … Heel Spur: Examination
The collection of laboratory parameters is usually not necessary for heel spur, because the diagnosis of heel spur can usually be established with certainty by means of the medical history and physical examination.
Therapy target Pain relief Therapy recommendations Analgesia (analgesics) using nonsteroidal anti-inflammatory drugs (NSAIDs; drugs that are not derived from sterols and act by inhibiting cyclooxygenase), e.g., acetaminophen If necessary, also infiltration of local anesthetics (local anesthesia) and/or glucocorticoids. If necessary, injection with botulinum toxin A (improvement of the pain in a painful fixed up to … Heel Spur: Drug Therapy
The diagnosis of heel spur can usually be established with certainty by means of the medical history and physical examination. Radiographic diagnosis is required only in cases refractory to therapy. Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics and obligatory medical device diagnostics – for differential diagnostic … Heel Spur: Diagnostic Tests
Surgical therapy for calcaneal spur is very rarely indicated. An indication for surgery should take into account that satisfactory pain relief can be achieved in 90% to 95% of patients within 12 months by combined conservative therapy measures. 2nd order Plantar complete or partial fasciotomy/surgical procedure to relieve pressure on muscle ligaments by unraveling the … Heel Spur: Surgical Therapy
To prevent heel spur, attention must be paid to reducing individual risk factors. Behavioral risk factors Misuse/overuse of the foot Predominant activities in standing position Change of footwear from padded shoes to thin soles Physical activity Athletes: Running (long distance runner) Sudden change of load (start of training after sports break). Overweight (BMI ≥ 25; … Heel Spur: Prevention
Often, a heel spur is asymptomatic, meaning there are no symptoms. The following symptoms and complaints may indicate a lower (plantar) heel spur (= plantar calcaneal spur): Load-dependent pain in the plantar medial heel area (= plantar fasciitis): Stabbing pain when walking (especially in the morning after getting up) or after inactivity. After initial improvement, … Heel Spur: Symptoms, Complaints, Signs
Pathogenesis (development of disease) The development of plantar fasciitis is considered multifactorial. It is a mechanical overload reaction from that leads to repetitive microtrauma. As a result, bone material accumulates at the attachment of tendons, forming thorn-like bone outgrowths. Depending on the location of the calcaneal spur, two forms can be distinguished: Lower calcaneal spur … Heel Spur: Causes
