L'opération d’une épine calcanéenne

Heel spur surgery is a surgical procedure performed by an expert to correct pain caused by inflammation of the plantar fascia. It is generally performed when other forms of natural and medical treatment have failed to produce satisfactory results.

However, although this operation is generally considered to be an effective solution for pain relief of heel spurs, it must be performed by a qualified physician.

Heel spur: what it is

Heel spur is a painful condition of the foot generally caused by inflammation of the plantar fasciitis. It manifests itself as intense pain when walking or running, and for patients suffering from this pathology, it can even make their daily activities rather difficult.

It is caused by excessive pressure on the calcaneuswhich is also the heel bone, and can be caused by poor foot alignment or the wrong choice of shoes. However, the pain caused can range from mild tingling to severe pain that limits movement. That's why we strongly recommend wearing shoes for heel spurs.

Major causes of heel spurs

The most common causes of heel spurs include :

  • Arthritis
  • Obesity and hormonal changes.
  • Plantar morphology (especially flat feet).
  • Overuse of tendons and foot muscles.
  • Poor posture.
  • Wearing inappropriate or too-small shoes.
  • Excessive practice of high-impact sports (running, dancing, etc.).

However, it's worth remembering that high-level athletes and people who engage in sports activities that involve excessive use of the feet are more likely to suffer from plantar fasciitis and, consequently, heel spurs.

How is heel spur treated?

To get rid of a heel spur for good, it's vital to take several steps to reduce pressure on the heel and treat the pain caused by inflammation. Treatments may include:

  • Rest.
  • Use of orthopedic inserts to relieve pressure on the heel fascia.
  • Use shoes adapted to your foot type.
  • Stretching exercises.

However, it's vital to know when to undergo heel spur surgery. If it turns out that these treatments, described as "natural treatments do not produce positive results, then surgery will be required to remove the heel spur.

Heel spur surgery techniques

 Heel spur surgery is an ultimate option for patients suffering from persistent or severe pain caused by the inflammation of plantar fasciitis. However, for treat heel spurDepending on the surgeon's opinion of the evolution of the heel spur, there are a number of heel spur surgery techniques. These include :

Minimally invasive surgery

This type of surgery involves reducing the tension on the facilitator and planing the heel spur to relieve or even eliminate persistent pain.

Endoscopic plantar aponeurotomy

This type of surgical operation involves lengthening theplantar fascia. It should be noted, however, that the method selected depends on the profile of both the specialist performing the operation and the patient.

Steps in heel spur surgery

Performing a calcaneal spur operation and putting an end to the pain caused by the inflammation of plantar fasciitis is no trivial matter. However, a series of steps is required to ensure a successful operation. Here, then, is a brief description of the procedure for a heel spur operation, with photo above.

Pre-operative assessment for heel spur surgery

Prior to any heel spur surgery, a pre-operative work-up is essential, with the sole aim of confirming the diagnosis. However, it should be noted that this pre-operative assessment includes X-rays, a biomechanical examination and an ultrasound scan.

However, in case of doubt, a complementary MRI scan may be performed to eliminate any risk of differential diagnosis. A consultation with an anaesthetist is also essential to prepare the patient for anaesthesia.

Anesthesia

Heel spur surgery can be performed under local or outpatient anaesthetic. For this purpose, thelocoregional anaesthesia can of course be accompanied by a light general anaesthetic or sedation, at the patient's request and in consultation with the doctor in charge.

Heel spur surgery

Before moving on to heel spur surgery, it's important to note that the surgical procedures performed by the surgeon during the operation depend on the type of operation chosen to treat the heel spur. There are two possible scenarios:

  • In the case of surgery minimally invasive surgerythe surgeon will make a small incision under the heel, and the operation will then be performed under X-ray control.
  • On the other hand, in the case of the so-called aponeurotomy on each side of the heel, the surgeon makes two small incisions of around 1 cm each. Throughout the operation, a mini-camera is placed in one of the incisions to visualize the aponeurosis.

What is the post-operative follow-up procedure for a heel spur?

Following surgical treatment of heel spurs, full weight-bearing walking can be resumed immediately, but anticoagulant treatment may be considered depending on the patient. In this case, to limit pain in the days following surgery, painkillers may be prescribed.

Recovery from heel spur surgery

However, it's worth remembering that for some patients, the pain caused by surgery may persist for a few weeks. So, the question many people ask themselves is how much time off work is required for a heel spur?

To address this concern, here are a few tips that can help you avoid this post-operative pain. In order to relieve heel pain from heel spurs after surgery, and depending on your body's ability to heal, you should then count on average :

  • Seven days to drive.
  • 30 days or more to gradually resume sport.
  • 30 days or more to wear your shoes normally.
  • One to two months to return to work.

Tip: As part of the post-operative follow-up, use of foot orthotics for around 6 months is necessary to support the arch of the foot.

Heel spur surgery advice

Calcaneal spur is a bony outgrowth of the arch of the foot that can cause the patient excruciating pain. As far as patients' opinions on this condition are concerned, treatment with orthopedic inserts and shoes can be effective when the pathology is only slightly advanced. 

Once a heel spur is advanced, the only valid treatment is surgery. However, it's vital to consult a highly qualified specialist if you suffer from this condition, as not all orthopaedic surgeons know what it is.

Which specialist can treat heel spurs?

If you're suffering from severe heel spur pain, there's no need to panic too much, as there are a number of competent healthcare professionals who can take charge of heel spur treatment.

However, before considering heel spur surgery, you should consult a rheumatologist or a physician specializing in physical medicine and rehabilitation.

You should also consult a physiotherapist if you wish to opt for shockwave treatment. But it's always important to remember that if surgery is required, you should always consult an orthopedic surgeon.