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Should I have a heel spur removed?

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Updated May 05, 2007

Question: Should I have a heel spur removed?
Answer: Heel spurs are often seen on X-rays of patients with plantar fasciitis. It used to be thought that this spur of bone "pressed" against the sole of the foot causing pain.

However, more recent understanding of this condition has shown that a so-called heel spur is seldom a cause of heel pain. Heel spurs are often seen in patients with heel pain and plantar fasciitis, but they are also commonly seen on X-rays of patients without heel pain.

What should be done about a heel spur?
Most often, nothing should be done to a heel spur. Surgery is seldom needed in the treatment of heel pain caused by plantar fasciitis and heel spurs. When surgery is performed, it is only after a lengthy trial of non-operative treatments.

The surgery performed for this type of heel pain usually consists of a partial release of the plantar fascia. The heel spur is almost always left alone, as this is not the cause of the pain. Often a nerve release is also performed at the time of plantar fascial release. This nerve, called the lateral plantar nerve, is located in the area of the plantar fascia, and can contribute to some of the pain with this condition. Most experts recommend releasing that nerve at the time of surgery to prevent it from causing persistent symptoms.

Sources:

Sammarco GJ, Helfrey RB. "Surgical treatment of recalcitrant plantar fasciitis" Foot Ankle Int. 1996 Sep;17(9):520-6.

Pribut SM, "Current Approaches to the Management of Plantar Heel Pain Syndrome" J Am Podiatr Med Assoc, January 1, 2007; 97(1): 68 - 74.

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