The foot is made up of many bones. One of them is the calcaneus - the bone in the heel. Heavy stress can cause a heel spur, a bony outgrowth on the heel. The stress causes small tears where the plantar tendon, or even the Achilles tendon, attaches to the heel bone. The injury inflames the area and causes pain.
Cause
The overload is caused, for example, by a too flat arch of the foot in old age, overweight, intensive sports or ill-fitting shoes. As a result, the arch of the foot collapses and the tendon underneath is forcibly stretched. With repeated stress or if this condition persists for a long time, the body tries to relieve the foot and deposits calcium and the tissue can become inflamed.
Symptoms
Many people do not notice the heel spur at first, because it does not always cause discomfort. However, if it is in an advanced stage, the heel hurts when stepping on it, as if a nail is stuck in the sole of the foot. Under stress, the discomfort usually increases. Affected persons can hardly step or roll their feet. In addition to the typical pressure pain, the symptoms also often include a pain when getting up in the morning.
Diagnosis
In most cases, the symptoms speak for themselves. Another indication is when the pressure on the front edge of the heel sole triggers pain at the back of the shoe or at the base of the Achilles tendon. There is swelling and redness, which the physician detects during the examination. In a lateral X-ray, the ossification is also clearly visible.
Therapy
The most important thing in treatment is relief. As part of a conservative treatment, your orthopedist in private practice can prescribe shoe inserts for this purpose, for example. Medication, cold therapy or shock wave therapy can also alleviate the pain.
If conservative measures do not work, heel spur surgery is an option. Here, the surgeon uses endoscopy to partially detach the plantar tendon from the heel bone, thereby reducing the strain or pull of the tendon on the attachment to the heel bone.

Stefanie Baudis
Foot and ankle surgery secretariat
- Tel.+49 2351 945-2386
- Fax+49 2351 945-2371
- sekretariat.knichel@hellersen.de