Complaints & connections · borters.ch
It is not the spur that hurts but the irritated tendon plate — stretching works better than insoles alone.
Also known as: heel spur · plantar fasciitis · heel pain
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
Sharp heel pain, typically with the first steps in the morning or after sitting for a while. The cause is usually an irritated tendon plate on the sole (plantar fascia) from overload, unsuitable shoes, lots of standing or excess weight. Worth knowing: the bony “spur” on the X-ray is often just an accompanying finding — many people have one without pain, and the pain comes from the fascia, not the bone. Usually improves with stretching (calf and sole), reducing load, good footwear and insoles; patience is needed, it often takes months.
While seated, pull the toes towards the shin and stretch the band under the foot for thirty seconds, three times — before the first step in the morning. That first step is the worst, and this takes the edge off it.
Many people with a spur on the X-ray have no complaints, and many with complaints have no spur. What is treated is the irritated band, not the bony spike — it does not have to be removed.
A shortened calf is the commonest reason it does not get better. Two minutes per side, best several times a day, over at least two months.
Barefoot on hard floors and flat shoes make it worse. A shoe with a slightly raised heel and a stable sole, plus a soft insole, often does more than any treatment at the practice.
Roll a chilled bottle back and forth under the foot for five minutes — cools and stretches at the same time. Pleasant, cheap, and one actually does it.
The bone spur itself does not hurt — it is also found in people without complaints. Painkillers and injections act on the irritated sole ligament, not on the spur; cortisone helps short term and weakens the ligament if repeated. What works most reliably over months is stretching of the sole and calf, several times a day over three months — in about eight out of ten people the complaints go within a year.
The pain is strongest on the first steps in the morning and eases after ten to thirty minutes of movement — that pattern is the identifying mark. About one in ten people experiences it once in life. A bone spur is found in about one in five people with no complaints at all. With stretching and insoles, complaints are gone at twelve months in about eight out of ten; the first three months decide the direction.
Still in bed, pull the toes towards the shin by hand, thirty seconds, three times. The tendon sheet shortens overnight — that is the reason for the first-step pain.
A stabbing pain under the heel when getting out of bed that eases after ten to twenty steps and returns during the day. This pattern is so typical that it almost makes the diagnosis.
On the inner side of the sole, where the tendon plate attaches to the heel bone, the pain can be reproduced exactly with the thumb.
The pain comes back after every rest — after the car journey, after the cinema. It is a start-up pain, not a load pain.
Pain at rest at night, numbness or burning in the sole, a swollen heel, pain at the back instead of underneath, or heel pain in a young person with a stiff back. Then the search goes on.
The heel pain itself is a mechanical overload and produces no inflammatory values. Raised values point to an inflammatory cause at the tendon insertions.
Only worthwhile when low back pain with morning stiffness joins the heel pain, especially in people under forty.
A suddenly very painful, reddened foot is more a gout attack than a strained tendon. The value can be normal during the attack.
500–1000 mg a day over 8 weeks; the studies concern joints, not the sole of the foot in particular. Stretching the plantar fascia in the morning has better numbers for this picture.
A deficiency causes bone pain at load-bearing places — the heel is one of them. Measured beforehand, otherwise it stays a guess.
The plantar fascia is connective tissue like a tendon — after menopause it becomes stiffer and less yielding. That is one of the reasons the complaints cluster between forty and sixty.
The cortisone injection into the heel eases for a few weeks and afterwards raises the risk that the fascia tears or the fat pad wastes away. Stretching in the morning has better numbers for this picture — and no such downside.
The plantar fascia carries body weight with every step. Losing 5–10 % shortens the duration of complaints in studies — insoles and stretching remain the main thing.
Stretching the calf and the tendon plate, in the morning before the first step — that is the treatment.
The Bladder meridian ends at the little toe and runs over the heel — heel pain is assigned to it. The back chain physiotherapy stretches runs along the same line.
At the inner ankle, right beside the tendon. One of the named points for heel pain; stretching in the morning has the better numbers.