1. Heel Spurs

2. What is a Heel Spur?  An abnormal growth on the heel bone  It is usually associated with Plantar Fasciitis  As the Plantar Fascia pulls away from the bone, the space is filled with calcification

4. Predisposing Factors  Pronated foot (flat foot)  Supinated foot (high arch)  Obesity  Improperly fitted or worn shoes  Women  Dancers  Gout

5. Facts  The heel strikes the ground with 2,000 lbs of force for every 100 lbs of body weight

6. Signs and Symptoms  Pain on center or inner side of the bottom of the heel  Pain could radiate into arch or ankle  Inflammation  Swelling  Painful first step in the morning

7. Examination  Palpate bottom of the calcaneus  X-rays

8. Treatment/Management  Over-the-counter anti-inflammatories  Ice compress  Ultrasound  Muscle stimulation  Stretching  Orthotics  Cortisone injections

9. Orthotics Arch Support Night Splint Heel Cups

10. Surgery  Preformed in the podiatrist’s office  Requires only a puncture under slight anesthesia  Piece of calcified bone is removed  No stitches neccessary

11. Post Surgery  Patient can walk and is usually pain free after about a week  Slight pain may persist for up to 6 months  Can return to sitting job but no heavy lifting for 8 weeks

12. Surgery

13. Non-evasive surgery  Extra-corporeal Shock Wave Therapy (ESWT)  Uses sound waves to stimulate blood and oxygen flow to the injured area which causes the break down of diseased tissue and growth of new healthy cells  The machine is called the Orbasone machine which consists of a portable vacuum machine with a movable arm  A jarsized electrode is placed on sight of pain and patient receives 1,000 to 4,000 high energy pulses every 2 seconds

14. Non-evasive surgery  Patient only experiences minor pain and bruising on the heel  Recovery time is only a few days

15. References  http://www.acfas.org/brheelds.html http://www.acfas.org/brheelds.html  http://www.ourfootdoctor.com/yourfeet_he el.shtml http://www.ourfootdoctor.com/yourfeet_he el.shtml http://www.ourfootdoctor.com/yourfeet_he el.shtml  http://www.footsmart.com/ProductRecords.aspx?category=HP&pgtitle=Heel%20Spur %20Relief&srccode=IP59 http://www.footsmart.com/ProductRecords.aspx?category=HP&pgtitle=Heel%20Spur %20Relief&srccode=IP59 http://www.footsmart.com/ProductRecords.aspx?category=HP&pgtitle=Heel%20Spur %20Relief&srccode=IP59  http://www.foot.com/info/cond_heel_spurs. jsp?source=overture http://www.foot.com/info/cond_heel_spurs. jsp?source=overture http://www.foot.com/info/cond_heel_spurs. jsp?source=overture

16. References  http://www.personalhealthzone.com/heels purs.html http://www.personalhealthzone.com/heels purs.html http://www.personalhealthzone.com/heels purs.html  http://www.footdoc-il.com/heel.htm http://www.footdoc-il.com/heel.htm  http://www.footcaredirect.com/heel.html http://www.footcaredirect.com/heel.html  http://www.thefootspecialist.com/heelspurs.html http://www.thefootspecialist.com/heelspurs.html http://www.thefootspecialist.com/heelspurs.html