From the Guidelines
The initial treatment for heel spurs should focus on conservative measures, including open-backed shoes, heel lifts or orthoses, NSAIDs, decreased activity, stretching exercises, and weight loss (if indicated), as recommended by the American College of Foot and Ankle Surgeons 1. The goal of these treatments is to reduce pain and inflammation, and to improve foot mechanics.
- Decreasing activity and using open-backed shoes can help reduce pressure on the affected heel.
- NSAIDs, such as ibuprofen or naproxen, can be used for pain relief and to reduce inflammation.
- Stretching exercises targeting the plantar fascia and Achilles tendon should be performed several times daily.
- Proper footwear with good arch support and cushioning is essential, and over-the-counter heel cups or orthotic inserts can provide additional support.
- Weight loss may be recommended if the patient is overweight, as this can help reduce pressure on the heel. It is essential to note that local injections of corticosteroids are not recommended as an initial treatment option 1. If symptoms do not improve within six to eight weeks, other diagnoses may need to be considered, and patients should be referred to a podiatric foot and ankle surgeon 1.
From the Research
Initial Treatment for Heel Spurs
The initial treatment for heel spurs typically involves conservative approaches, including preventive measures and non-invasive treatments. According to 2, it is essential to consider the differential diagnoses and underlying medical conditions that may contribute to the symptoms of heel spurs.
Conservative Treatments
- Conservative treatments, such as orthoses, physical therapy, and physical agents, may be effective in treating heel spurs, as mentioned in 3.
- A study published in 4 found that conservative treatments were effective in treating heel spurs, with 30.8% of patients experiencing favorable outcomes.
- However, the same study found that corticosteroid injections were associated with higher patient satisfaction, with 40.9% of patients experiencing favorable outcomes.
Corticosteroid Injections
- Corticosteroid injections may be used to treat heel spurs, especially when conservative treatments are not effective, as discussed in 3.
- A review of 39 studies on injected corticosteroids for treating plantar heel pain found that steroid injection may lead to lower heel pain visual analogue scores in the short-term, but the evidence was rated as low quality, as reported in 3.
Other Treatment Options
- Other treatment options, such as extracorporeal shock wave therapy (ESWT), laser, and radiation therapy, may also be considered, as mentioned in 3.
- However, the evidence for these treatments is limited, and further research is needed to establish their effectiveness, as noted in 3.