Heel spurs are a form of pathological changes in the foot area, the basis of which is the chronic inflammatory process in the plantar fascia at the place of attachment to the calcaneus. Another common and more correct name for this disease is plantar fasciitis. It is used to a greater extent by foreign specialists, while the term "calcaneal spur" is a more common diagnosis of domestic doctors. A detailed description of one of the sections of this pathology, namely the cause of development of the heel spur, is given in this article.
Mechanisms for the maintenance of the inflammatory process with a calcaneal spur
The opinion that the calcaneal spur is just a pointed bony growth that irritates surrounding tissues is vicious. Undoubtedly, this disease includes it, and it contains an even wider range of pathological changes. All links of the pathological process support the existence of each other, closing into a typical vicious circle. Among the main sequential pathogenetic elements of the anomalous chain, we can distinguish:
- Incorrect redistribution of loads on the foot either against the flattening of its arch( flatfoot) or weakening of dense tendon-fascial plantar formations.
- Excess load on the foot in general and the plantar fascia in particular.
- Chronic overstrain and overgrowth of the plantar fascia with an epicenter of force effects on the area of its attachment to the calcaneus.
- Microfractures of fascial fibers.
- The emergence of a slow inflammatory process in response to traumatization in order to replace the formed defects with a connective tissue.
- The continuing overstretch of the fascia against the background of its inflammation aggravates the course of the pathological process.
- Formation of the focus of chronic inflammation, which ends with the deposition of calcium in fascial bundles.
- Formation of bone growth in the calcaneal region, which causes additional traumatization and pain syndrome.
It's important to remember! The main manifestation of the heel spur is a different degree of pain syndrome in the calcaneal region. The main mechanisms of the disease are associated with overload, hyperextension and microtraumatism of the attachment site of the plantar fascia to the heel bone and the inflammatory process caused by them. Therefore, the disease has another name - plantar fasciitis, which is more correct and reflects the true nature of the pathological process!
Predisposing and producing factors
A healthy foot is characterized by the following features:
- strong bones that are correctly connected to small joints and half-joints of the foot;
- is a strong tendon, ligament and fascia of the plantar area;
- well formed arch of the foot.
All these elements are extremely important for the exercise of walking and support function with the sole of the foot. Due to the correct arch, each episode of the soles contact from any surface during walking is softened and absorbed. Such a physiological protective mechanism protects all structures of the musculoskeletal system and internal organs from excessive shaking.
Schematic representation of calcaneal spur
If, due to certain reasons, the plantar fascia experiences extreme loads, it overstrains, inflames and loses its functional abilities. To lead to this can:
- congenital or acquired flat feet( increased pronation and flattening of the arch of the foot);
- general weakening of the structure of connective tissue formations in the body, in particular the plantar fascia( age changes, systemic diseases);
- increased foot loads( lifestyle and occupational activities, obesity and transient weight gain in pregnancy, hypertonicity and constant muscle tension of the posterior surface of the shin).
Description of Common Causes ofDisease
The causes of calcaneal spurs are divided into predisposing and producing. The first create a prerequisite and a background for the development of pathology, the latter - directly trigger the inflammatory process. In each specific case of the calcaneal spur, the combination of these factors is of an individual nature. The general pattern is this: the more weakened or stretched the plantar fascia, the smaller the load can cause it to fail. But even a foot with minor anatomical and functional changes can be affected by the calcaneal spur against the background of excessive physical exertion.
Compaction of the arch of the foot
According to the views of foreign experts, it is the flattening of the foot of varying severity that becomes the main cause of the calcaneal spur in more than 90% of cases. Even everyday loads on this background are enough to form an inflammatory process at the attachment point to the heel of the plantar fascia. Improperly installed on the surface of the foot can not create an adequate support. This causes a redistribution of the muscle tone, a hyperextension of the soft tissue formations of the plantar area, which provokes an inflammatory process in them and further aggravates the flatfoot.
Compaction of the arch of the foot - the main factor that increases the likelihood of calcaneal spurs
Elevated load on the foot
If the foot is in a constant voltage for a long time, caused by increased loads, then sooner or later there will be a secondary flattening of its arch. It is quite natural that against this background the unadjusted plantar fascia can become inflamed, which is manifested by the clinical picture of the calcaneal spur. To lead to this are capable of certain reasons:
- classes in power and other sports, associated with high loads on the lower limbs;
- heavy physical labor;
- long stay on legs;
- pregnancy in the late term and postpartum period.
Among the reasons for the development of the heel spur there are those that do not directly affect the onset of the disease. Their presence can enhance the pathological interaction of provoking and producing factors. Therefore, they are called secondary causes. These can be:
- Age changes in the soft tissue and bone structures of the foot, most often occurring after 40 years.
- Acute and chronic trauma of the foot. Sometimes the origin of the heel spur is associated with a heel kick into any hard surface. This is the most common cause of calcaneal spur in young people.
- Diseases of connective tissue of a systemic nature. Persons with a history of rheumatoid arthritis, Bechterew's disease, lupus erythematosus, various arthritis have a higher risk of a calcaneal spur.
- Exchange disorders in the body. The most common disease is gout. Against this background, the heel spur appears much more often even in persons with a normal arch of the foot and is characterized by a persistent current.
- Diseases, accompanied by a violation of the arterial blood circulation of the lower limbs. Plantar fascia, devoid of adequate blood supply, becomes more vulnerable to stress.
Heel spur, being a relatively simple pathogenetic disease, has many causes of development. From the combination of all causative factors and congenital anatomical features of the foot, the likelihood of developing the disease depends.
- Mechanisms of inflammation in the calcaneal spur
- Predisposing and producing factors
- Description of common causes of the disease