Surgery for heel spur syndrome?

Dear Alice,

A friend of mine has been diagnosed with heel spur syndrome by his podiatrist. The prognosis is surgery and then recovery for two months. Are there any alternative steps that can be done which will provide the same results? That is relieve the pain other than the usual steps like, orthopedic shoes, sole supports, etc. Thanks.

— Ride 'em cowboy

Dear Ride ‘em cowboy, 

First off, kudos to you for looking out for your friend and their health! However, it’s difficult to answer your question without knowing more about your friend’s condition. For example, how long has your friend been experiencing symptoms? Has he sought a second opinion? Has he tried other treatments? While it’s impossible to hypothesize treatment options for your friend without more information, there are some general recommendations to discuss that might shed some light on the situation. Namely, that the great majority of individuals with heel spurs, plantar fasciitis, and other types of heel pain are able to resolve discomfort without surgery or any other intensive or invasive treatments. In fact, 90 to 95 percent of heel spur patients are able to resolve their pain without surgery. However, it may still be necessary for some cases.  

To start, it can be helpful to talk about what a heel spur is. These bony growths usually form when the ligament that connects the heel bone to the bones in your toes, also known as the plantar fascia, becomes inflamed. This inflammation usually occurs when the ligament is over-stretched from either running, wearing poor-fitting shoes, or being overweight. In turn, the body responds to this added stress by building extra bone around the inflammation, resulting in a heel spur. However, heel spurs aren’t usually the cause of heel pain, as only about half of those with heel spurs feel any pain from them. In most cases, heel pain stems from conditions that result in inflammation of the ligaments in your foot, such as plantar fasciitis. In terms of other treatment options, there are several non-surgical treatments for heel spur syndrome that are usually recommended before surgery is considered. In fact, only about 5 percent of those with heel pain fail to improve with some form of non-surgical treatment. Here are some examples of different non-surgical treatments that your friend can use to help with their heel pain: 

  • Ice: Using an ice pack on the affected area, for 10 to 15 minutes, especially after strenuous or high-impact activity or long periods of standing, may help the pain dissipate. 
  • Stretch: There are several stretches that your friend can utilize to help relax other muscles and tissues near the heel, which can help alleviate symptoms. 
  • Massage: Using your fingers and knuckles to massage the affected area for around one to five minutes at a time can help alleviate pain even promote some mobility. 
  • Foot inserts: As you mention, wearing arch supports, insoles, heel cups, and other supportive footwear can lead to significant improvement of symptoms. If necessary, prescription orthotics, walking aids, or night splints may also be used. 
  • Over-the-counter and prescriptions drugs: Anti-inflammatory drugs may be taken to treat pain associated with heel spurs and plantar fasciitis. However, long-term use of these drugs aren’t recommended as treatment. 

In addition to these home remedies, a health care provider might also recommend corticosteroid injections to reduce any inflammation and pain. Furthermore, they could also recommend extracorporeal shock wave therapy, a treatment that sends shock waves through the foot to help relieve pain. Although this procedure isn’t surgical, along with surgery, it's considered a last resort to resolve heel pain. 

These recommendations may not apply to your friend’s particular condition; however, knowing more about the typical treatment and prognosis for heel spur syndrome can help your friend make an educated decision regarding surgery. Given that your friend has already visited a health care provider, it may be beneficial for them to seek a second opinion. They may be able to see if there are any other underlying causes that may be contributing to your friend’s heel pain or other ways to approach treatment for the heel spur syndrome. 

 Wishing your friend the best of luck! 

Last updated Jul 16, 2021
Originally published Feb 16, 1995

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