- Mechanism of development of calcaneal spur
- Causes of calcaneal spur
- Symptoms of the calcaneal spur
- Diagnosis of calcaneal spur
- Treating the calcaneal spur
- Prophylaxis of calcaneal spur
- Diet with calcaneal spur
- Heel spur in children
- Heel spur in pregnant women
Heel spur (plantar fasciitis) is a chronic disease that is a consequence of microtraumas of the plantar ligament (fascia). An excruciating pain is caused by the resulting bony proliferation (osteophyte) - a pointed spine up to 12 mm long, compressing surrounding soft tissues. Neoplasm may not be noticeable externally, but to locate it simply by pressurizing the heel.
Mechanism of development of calcaneal spur
Plantar fascia is a fibrous tissue, a ligament connecting the heel bone with the heads of metatarsal bones. It supports the longitudinal arch of the foot. During walking, the fabrics of the plantar fascia experience the greatest tension at the site of its attachment to the heel of the heel. Normally, microtraumas of the plantar ligament are overgrown, restored independently. But the permanent injury of the fascia often becomes the cause of perestroika periosteasis, the bone tissue itself.
The mechanism of the planar fasciitis can be associated with:
- Mikrotovamami ligament in the area of its attachment;
- Development of aseptic (non-microbial) inflammation in the area of trauma;
- Irritation with loads of the periosteum of the calcaneus.
In the zones of inflammation, calcium salts are deposited, forming an osteophyte (heel spur). According to X-ray studies and studies using magnetic resonance diagnostics, physicians found that 40% of the "spines" are located in the plane of the fascia, and 50% above it. The structures-the "culprits" of their formation are the flexor muscles of the toes.
Causes of calcaneal spur
Annually more than 2 million people are forced to apply for the treatment of the calcaneal spur, with 70-80% of them being women, more often urban residents over the age of 40. Physicians have several main causes of the disease:
- Flat feet - is the cause of osteophyte formation and growth in 90% of all cases;
- Age-related changes - disorders in the blood supply system of the lower extremities, reduced regenerative abilities of tissues;
- Overweight - increased stress on the feet of a person when walking;
- Trauma, pathology or disease of tissues, nerves, vessels of the lower extremities - gout , diabetes, rheumatoid arthritis , etc.
Symptoms of the calcaneal spur
The formation and development of an osteophyte can be asymptomatic, for example, if the cause was not permanent. In some cases, calcaneal spur is detected accidentally during an X-ray examination for other indications.
The first symptom is a feeling of discomfort or "nail" in the heel when walking. This symptom is associated with the pressure of bone formation (osteophyta) on soft tissues. Although growths in the form of a "nail" almost do not occur. At one time in medicine there was an opinion that the neoplasm is a "continuation" of the heel bone.
The intensity of pain depends more on the location of the build-up than on its size. Painful sensations are stronger if the "spur" is formed close to the nerve endings. At the initial stage of the build-up of the build-up, the pain may disappear for a time, then resume again.
In the beginning, pain can only be with the first "starting" steps - when you get up in the morning or after any other long break in movement. But after the first 5-6 steps, the pain disappears. In the future, on the contrary, the pain increases with increasing loads.
In the absence of treatment, pain also occurs in a state of rest. Gradually, in the area of injury, insoluble calcium compounds accumulate. By irritating the mucous membranes of the joints surrounding the soft tissues, they also cause pain. The pain is acute, cramping or aching. Strengthen and pass it can also gradually or suddenly.
The time from the first symptom to severe pain can range from 2 weeks to several months.
The second symptom is a consequence of the first - a change in gait. When there is discomfort in the heel region, the patient involuntarily tries to unload it. According to medical statistics, gait disturbances are noted in 93% of cases. An incorrect distribution of the body's gravity to the anterior parts and the outer edge of the foot not only changes the gait, but also provokes the development of transverse flatfoot. It is especially difficult for people with heel spurs on both legs.
Athletes identify symptoms-precursors of inflammation of the plantar fascia with a "singing string" test. In the standing position of the athlete, the doctor maximally bends the thumb (upward) and jerks along the "stretched string" (fascia) along and across in jerky movements. With its inflammation, the athlete feels soreness and pulls out his leg. The appearance of the heels can remain unchanged.
Diagnosis of calcaneal spur
- Bechterew's disease;
- rheumatoid arthritis;
- Osteomyelitis ;
- Bone tuberculosis ;
- Trauma - stretching of the tendons, bruises;
- Inflammation in the foot or various infections, including intestinal, urogenital.
In addition to collecting anamnesis, the doctor appoints a number of laboratory and instrumental studies:
- Blood test - general, biochemical;
- Analysis of urine;
- MRI of the foot;
- X-ray examination of the foot.
The purpose of the activities is not just the diagnosis, but also the identification of the cause of the disease, the degree of its severity. In the presence of concomitant diseases, the doctor can recommend the advice of other specialists.
Treating the calcaneal spur
The method of treatment of the calcaneal spur is selected individually. Attempts for self-treatment can only aggravate the situation - burns, soft tissue damage, partial loss of mobility (movement with crutches).
Modern medicine offers several methods of treating the disease:
- Physiotherapeutic complex;
- Shock-wave therapy;
- Laser exposure;
- Removal of the spine surgically.
The methods of conservative treatment, first of all, are aimed at the removal of inflammation in the affected foot tissues. Selection of the drug is carried out by a doctor orthopedist individually.
These are various gels, ointments, cream, infusions - are more effective at the initial stage of the disease.
Another method is injecting painkillers and anti-inflammatory drugs into the heel joint. Efficacy of injections is higher, but it is quite painful and painful procedure. In addition, one injection is not enough. Injections are performed only by a surgeon. The dosage of the chosen preparation, the depth and accuracy of its administration are important. Errors are fraught with the development of inflammation, osteoporosis, the formation of suppuration. Frequent injections can damage or destroy fascia tissue.
Plasters containing painkillers, antiseptics, natural ingredients are most convenient to use.
Analgesics are not a cure - this is only one way to relieve pain. Less painkillers - the likelihood of addiction and the emergence of dependence on them.
Contraindications - individual intolerance of the components that make up the medicines.
A complex of gymnastic exercises, massage, mud and mineral baths, ultrasound therapy can reduce exacerbation.
To improve the medicamentous effect on the areas of affected tissues:
- Electrophoresis - drugs penetrate deep into soft tissues under the influence of galvanic current (low-voltage electrical impulses);
- Sonophoresis - penetration of medicines is carried out with the help of ultrasonic waves.
A physiotherapy complex may also include injections of corticosteroids-anti-inflammatory steroid preparations mixed with an anesthetic are injected into the sole or heel area.
A wide range of activities allows you to select funds for almost any patient
Shock Wave Therapy
Under the influence of ultrasonic pulses, calcium deposits "break up" into tiny particles that are excreted from the patient's body with blood flow.
Simultaneously, shock wave therapy activates the process of regeneration of soft tissues, reducing inflammation, swelling.
The use of shock wave therapy at the initial stage allows you to remove the heel spur completely. Using the technique in advanced cases removes inflammation, inhibits or completely stops the growth of calcium build-up.
The procedure has contraindications:
- Low blood pressure;
- Bleeding disorders;
- Heart rhythm disturbances;
- Intoxication, for example, due to intestinal poisoning, taking medications;
- Disorders of the nervous system;
- Malignant neoplasms;
- Thrombophlebitis in the area of the affected area.
Also, the method is contraindicated in the presence of acute infections of any nature.
Ultrasonic waves relieve pain, reduce inflammation due to deep warming of tissues. Penetrating the damaged fascia, ultrasound accelerates its healing at the cellular level. Muscles relax, blood flow to the ligaments and tendons increases, edema decreases.
A beam of light is sent to the damaged area. Positive effect is observed after 2-6 sessions, depending on the characteristics of the disease, the characteristics of the patient's body. Penetrating to great depth, the laser stimulates metabolic processes in damaged tissues, accelerates their regeneration.
The purpose of the previous methods is to relieve inflammation, prevent and inhibit the growth of bone formation, regenerate soft tissues. Surgical intervention allows you to completely get rid of the build-up, but does not guarantee its reappearance, so this method doctors only apply in extreme cases.
The extent of surgery depends on the nature of the disease. During surgery, the plantar fascia is partially or completely cut, with simultaneous removal of the spurs and damaged tissues. But with complete (disconnecting) fasciotomy, the anatomy of the foot is disturbed. As a result, a change in gait causes disability.
Minimal invasiveness is characterized by radiofrequency microtenomy (burning out). Under the influence of high-frequency electromagnetic radiation destroy damaged tissues, as well as nerve fibers, which allows to remove the pain syndrome completely.
The effectiveness of any technique depends on the timely diagnosis of the disease and the implementation of a set of preventive measures to prevent its development. Do not use numerous "folk" means, even if they helped friends. In the best case, they will prove to be simply ineffective.
Prophylaxis of calcaneal spur
Preventive measures to prevent and develop the disease can be summarized by the abbreviation - HLS (healthy lifestyle). There are several areas of prevention of calcaneal spurs:
- Control of body weight;
- Prevention of premature aging of the osteoarticular apparatus;
- Prevention of injuries, wear of the osteoarticular apparatus;
- Timely diagnostics and qualified treatment of diseases of the musculoskeletal system.
Corns, ingrown nails, bruises often cause changes in the position of the foot and create conditions for trauma to the plantar ligaments. In the presence of discomfort, pain in the area of the heel should immediately consult a doctor and begin treatment.
Controlling body weight
Excess body weight not only increases the load on the longitudinal arch of the foot. Simultaneously, a large weight can be evidence of metabolic disorders, various diseases that can directly or indirectly affect the condition of the plantar fascia, stimulate the formation of the calcaneal spur.
Prevention of aging of the osteoarticular apparatus
Active lifestyle, proper nutrition, control over your health will avoid premature aging of the joints, bones. Particular attention to the state of bone tissue should be given to women after 40 - the risk of osteoporosis. Medicine offers many mineral-vitamin complexes to support the health of the musculoskeletal system.
Preventing injuries and wear
Wearing the wrong shoe, heavy loads during sports training are also a common cause of heel spurs.
Shoes with high heels should be worn no more than 3-4 hours a day. Orthopedists do not recommend flip-flops, sandals and other kinds of footwear without a back for constant wearing. Shoes should be with a small heel - 3-4 cm and firmly keep on their feet.
For flat feet, you must purchase orthopedic shoes or use correcting insoles.
According to medical statistics, almost 25% of people involved in running, face pain in the heels. The reason is an unprofessional approach to training. Doing sports are useful only when doing the exercises correctly. During running, jumping, walking, you need to monitor the position of the foot, gradually increase the load. In the case of injuries, sprains, professionals are advised to reduce the intensity of training or abandon them until complete recovery. You need to resume the interrupted classes gradually.
The effectiveness of treatment depends mostly on the timely diagnosis of the disease. Address to the doctor at the first signs of the calcaneal spur will avoid its complications. People who are in the "risk group" - with flat feet, pathologies and diseases of the joint-bone apparatus, regularly undergo a check-up. Self-medication with medicinal, folk remedies is unacceptable! Use of medical equipment should be carried out only on the advice of a doctor and under his supervision.
Diet with calcaneal spur
One of the most important places in the treatment of heel spurs is diet. The osteophyte is formed from salts of uric acid. Therefore, the main goal of the diet is to normalize the acid-base balance, remove salts and reduce the risk of inflammatory processes in the body. Fasting can provoke an exacerbation of the disease, therefore it is completely excluded.
- Decrease in consumption of fish, meat, cereals, low-fat dairy products;
- Constant consumption of vegetables, fruits, fatty dairy products;
- Plentiful drink - up to 3 liters a day: alkaline mineral water, decoctions and tinctures of dogrose, coriander, nettle, chicory; Decrease in intake of easily assimilated carbohydrates - sugar, honey, sweets, chocolate, etc.;
- Refusal of mayonnaise, ketchup, spicy seasonings;
- Refusal of alcoholic beverages, including beer;
- to give up smoking.
Heel spur in children
The reasons for the formation of the calcaneal spur in children are in many respects similar to the "adults":
- Flat feet;
- Diseases and pathologies of the musculoskeletal system;
Until the age of 18, the baby's foot has good elasticity and is therefore easily deformed.
Treatment and prevention of heel spur in children
Methods of treatment are also similar to adults and are selected depending on the age of the child, the severity of the disease. More often in the treatment of calcaneal spurs in children, it is sufficient to use only conservative methods of treatment.
Complicated with symptoms. An indication of the formation of the calcaneal spur in the child may be complaints of pain, changes in gait, posture, and decreased motor activity. Be sure to pay attention to the state of children's feet. Corns, ingrown nails, bruises cause the child to put the stalk incorrectly, which can cause deformation of the foot and a fascia injury.
For a child shoes, sandals, sneakers are not just shoes, but also a "form" for his feet. Therefore, it should be selected according to the age of the child. Boots with a soft sole fit only "sliders", only occasionally standing on the legs. Toddlers taking their first steps should choose shoes with leather soles on a small heel - about 1 cm and with a good fixation on the foot.
If slippers are not recommended for adults, then for children they are forbidden! The presence of such shoes on the shelves of stores is not a confirmation of its "usefulness."
Heel spur in pregnant women
In addition to general reasons, the risk of heel spur formation in pregnant women is due to physiological changes - softening of ligaments during pregnancy. Diagnosis and treatment of a future mother is hampered by the limitations of the use of certain methods and medications. Therefore, preventive measures are particularly important:
- Daily foot massage (not with swelling);
- Adherence to diet;
- Refusal from bad habits - alcohol, smoking;
- Wearing comfortable shoes with 2-4 cm of heel lift;
- Use of preventive insoles.
Pregnant women (especially in the third trimester) can not stand still for a long time - turns, stops, but quiet walks are useful.
In the case of the formation of the calcaneal spur during pregnancy, treatment is usually limited to gentle analgesic measures - ointments, plasters, less often injections, so as not to cause harm to the health of the baby.
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