There are many causes of the heel pain, but heel spur (epin calcanei-plantar fasciitis) is the most commonly encountered pathology among the others. This problem makes a sense as if there is a needle penetration or a sharp piece of stone is irritating the heel while standing.

What is heel spur?

An elastic band (plantar fascia) is present under the sole of the foot. The function is supporting the arch of the foot and maintaining the curve of the foot sole. This band has connections to the fingers resembling a fan, however has a single connection to the heel point. This distributes the weight to the fingers almost evenly but causes stretching of the band at the heel connection. With time, excessive stretching of the band causes a bone formation at the base of the heel resembling a thorn of rose. Heel spur is the name of this prominence and excessive stretching of the band is the cause of the pain.

Why heel spur occurs?

3 factors are effective on formation of heel spur;

• Excessive loading of the foot: overweight
• The timing of the load on the foot: standing too long time on foot
• Wearing shoes or slippers that are not supporting the arch of the foot: improper foot wear

Presence of one or more of those factors causes stretching of the plantar fascia resulting in formation of heel spur.

How are the symptoms?

In heel spur, the pain is located just under the heel, a little bit medial to the long axis of the foot. In 90% of the cases, the pain is present in single side. In bilateral cases, an underlying etiology like rheumatology may be present. Typically the pain occurs in first steps and continues intensively 5-10 minutes than gradually decreases. For this reason, it is typical that the patient describes an intensive pain when she get off the bed in the morning and step on the foot. The reason for this sudden pain in the morning is, sudden stretching of the plantar band which shortens and relaxes during night while sleeping.

What is the treatment?

Surgical treatment is not recommended in heel spur. For this reason most of the treatment is conservative. Those mainly include weight loss, limitation of long standing and wearing shoes and slippers having in sole supplement for supporting foot arch. Anti-inflammatory medication is beneficial for both resolving inflammation and preventing pain. In resistant cases corticosteroid injection may be tried which is quite effective in treatment.

Topuk dikeninin cerrahi tedavisi önerilen bir yöntem değildir. Bu nedenle tedavinin büyük bölümünü koruyucu yöntemler oluşturur. Bunlar öncelikle kilo verme, uzun süre ayakta durmama ve ortası kavisli ayakkabı giymektir. Bize başvuran kadın hastaların büyük bölümü genelde sonbaharda gelir. Bunun muhtemel sebebi de kadınların yaz boyunca giydikleri tabanı düz olan terliklerdir. Bu nedenle topuk dikeninin önlenmesinde de tedavisinde de ayakkabı ve terlik seçimi önemlidir.