From the Guidelines
The management of a calcaneal spur should begin with conservative treatments, including open-backed shoes, orthoses, NSAIDs, decreased activity, stretching exercises, and weight loss, as these measures have been shown to be effective in reducing symptoms and improving quality of life 1. The approach to managing a calcaneal spur involves several key components:
- Conservative measures:
- Open-backed shoes to reduce pressure on the area
- Orthoses or heel lifts to support the foot
- NSAIDs to reduce pain and inflammation
- Decreased activity to avoid exacerbating the condition
- Stretching exercises to improve flexibility and reduce tension
- Weight loss, if indicated, to reduce pressure on the foot
- If symptoms persist, consideration may be given to:
- Immobilization to allow the foot to rest and recover
- Local injections, although corticosteroid injections are not recommended as an initial treatment option 1
- In refractory cases, more invasive treatments may be considered, including surgery to remove the heel spur or correct any underlying biomechanical issues. It is essential to note that the primary goal of treatment is to reduce symptoms, improve function, and enhance quality of life, rather than solely focusing on removing the heel spur. A stepwise approach, starting with conservative measures and progressing to more invasive treatments only if necessary, is recommended 1.
From the Research
Management of Calcaneal Spur
The management of calcaneal spur involves both conservative and surgical approaches.
- Conservative therapy is recommended as the initial treatment for calcaneal spur, as suggested by 2.
- If conservative measures fail, surgery may be considered, with various techniques available, including:
- Open heel spur surgery, which has been shown to be effective in reducing pain and improving function, as reported by 3.
- Endoscopic treatment, which involves a comprehensive approach to treating calcaneal spur syndrome, including removal of the calcaneal spur and release of the plantar fascia, as described by 4.
- Percutaneous drilling of the calcaneus combined with mid-sole release of the plantar fascia, which has been shown to be a effective and minimally invasive technique, as reported by 5.
- The choice of surgical technique depends on the individual case and the surgeon's preference, with consideration given to the potential risks and benefits of each approach, as noted by 6.
- Postoperative care and rehabilitation are important aspects of management, with patients typically requiring a period of rest and rehabilitation after surgery, as described by 3.
- It is also important to address any underlying factors that may be contributing to the development of calcaneal spur, such as being overweight, as noted by 6.