Synonyms
calcaneus spur, calcaneus spur, lower heel spur, upper heel spur, dorsal heel spur, fasciitis plantaris
Causes of pain
The main symptoms of heel spurs are usually moderate to severe pain. This is due to the fact that the heel spur, which is a bony projection in the area of the calcaneus, exerts mechanical pressure on the surrounding tissues. Depending on the type of heel spur, other areas of the foot are affected.
As a rule, all heel spurs are closely associated with the insertion points of the Achilles tendon. Whether it is the upper or lower heel spur, there is always increased pressure on the Achilles tendon, the associated muscle or the nerve tracts. Pain from a heel spur is caused by two different factors: pressure and impaling.
Pain induced by pressure
A heel spur is additional tissue that is not naturally intended to be this way in its shape and space requirements and can develop over time. In short, the space a heel spur requires is not available. The structures in the ankle and heel area are too narrow.
These are the outer ligaments of the ankle, which are tightly attached on both sides to the end extensions of the tibia and heel bone to secure the foot to the lower leg. There are numerous blood vessels, such as the artery dorsalis pedis and the artery tibialis posterior and finally numerous nerve tracts responsible for the sensitive and muscular supply. Important, and particularly affected in heel spurs, are the terminal branches of the posterior calf muscle, which is attached to the heel bone as a tendon.
Almost everyone knows the term Achilles tendon, which is used as a representative of this muscle attachment. If a heel spur now develops slowly, the space in the area of this tendon becomes increasingly smaller. The tendon in turn rubs directly over the heel spur with every foot movement.
On the one hand this can make the tendon dangerously thin, on the other hand heel spur formation almost always proceeds with an inflammatory change of this tendon. The rubbing on the one hand and the inflammatory changes on the other hand therefore lead to sometimes very strong pain. While the pressure on the tendon is increased, the pressure is passed on to other areas of the foot and the surrounding tissue. The Achilles tendon also always tries to escape the pressure of the heel spur to a certain extent and is pushed in the opposite direction, which in turn leads to an increase in pressure on nerves, blood vessels, ligaments or muscles.