b. Heel Pain. It is no wonder, then, that there are foot disorders of the heel. The
first indication of a foot disorder of the heel may be pain. An individual may feel pain on
the plantar surface of the heel (the sole of the heel). Such pain is usually caused by
strain at the periosteal attachment of the plantar fascia and the flexor digitalis brevis.
(See figures 2-4, 2-5, and 2-6.)
c. Types of Heel Disorder. There are several types of foot disorders of the
heel. Included are the calcaneal spur syndrome (fig 2-8), calcaneal fat pad
displacement, Sever's disease, Haglund's deformity, retrocalcaneal space pain, and
metatarsalgia pain.
2-4.
CALCANEAL SPUR SYNDROME (HEEL SPUR)
A calcaneal spur is a bony growth from the plantar surface (sole of the foot) of
the calcaneus (heel bone).
a. Pain. Also called a heel spur, this spur can cause an individual pain when he
walks. The spur grows forward in the direction of the plantar fascia. The individual may
have no specific symptoms, except for pain.
b. Treatment. The spur is treated with corticosteroids and lidocaine injections.
Treatment is as follows:
(1) Administer one ml of 10 mg triamcinolone acetonide in 1.5 ml of 2
percent lidocaine with epinephrine.
(2)
Strap to relieve strain.
(3)
Refer the patient to podiatry for biomechanical evaluation.
Figure 2-8. Calcaneal spur syndrome.
MD0577
2-6