There are several things that may cause pain in the heel, one of the most common seen in this office is plantar fascitis.

Now I am sure many of you have heard of heel spurs and have been told that it is the heel spur that cause the pain in your heel.

It has been my experience that it is not so much the heel spur that causes the heel pain as it is the mechanism that causes the heel spur to form that produces the pain.  Bone is dynamic, it will respond and change according to pressures that are applied to it.

The plantar fascia is a thick band of tissue that runs from the heel bone or the calcaneus and fans out to the ball of the foot.  When you stand down and your arch starts to flatten out, the plantar fascial band begins to stretch and in doing so, pulls on the calcaneus.  In individuals with a tight plantar fascial band or a lot of arch motion this plantar fascial pull will cause the calcaneus to respond to the stress by          producing a bony out growth at the area where the plantar fascia attaches.  This produces the heel spur.

In the case of the heel spur, the plantar fascia pulling the heel produces the spur.  The spur, therefore, is a result of the dynamic pressure produced at the origin of the plantar fascia of the calcaneus.  The pain produced in this case is caused by stress and strain on the plantar fascia. 

The pain can be felt anywhere along the plantar fascia, more commonly at the origin along the calcaneus, but it can also be felt mid-arch or out in the ball of the foot.

Depending on the problem there are many ways to treat the heel pain; anti-inflammatory drugs, steroid injections,        orthotics and heel pads, stretching and muscle          strengthening exercises, surgery is also an option.  What type of treatment you need will depend on what the problem is, as well as your work and activities.

If there is one thing I would like you to learn it is that the heel spur is usually not the cause of your pain, but is a result of the mechanism causing the pain.  A heel spur is not a sure sign that surgery is required to remove the spur and the pain.  It has been my experience that a fair number of heel pain cases can be treated successfully with out removal of the heel spur.