10/01/2023
Most if not almost all people think heel spurs grow into the plantar fascia. The spur (enthesophyte) forms as a result of chronic inflammation and is a result of the plantar fasciitis and is not the cause of the pain.
Surgery to “remove heel spurs” does not work by removing the spur. The surgery’s purpose is to cut the plantar fascia which may reduce pain but compromises the structural integrity of the foot. They remove the spur as part of the debridement process of removing the damaged tissue.
We manage plantar fasciitis by using the non-invasive treatment modality Shockwave to stimulate healing, decrease inflammation, reduce scar tissue, and eliminate pain by regeneration of the plantar fascia along the insertion.
We also can use ultrasound-guided platelet rich plasma (PRP) in more advanced or chronic cases to add in the powerful healing elements of PRP with regenerative stimulation by fenestration of the fascia with the needle. This creates multiple small holes in the tissue to signal healing, break up scar tissue, aid in fluid/oxygen tissue exchange, and deliver the PRP directly into the tissue to heal from the inside out.
This CT scan (second image) shows the spur is underneath the plantar fascia, the gray band marked by arrows. This soft-tissue structure is targeted, the spur is irrelevant in causing clinical symptoms. Many people have spurs with no pain, and some have extreme pain without a spur present. A spur just indicates that this is a site where chronic inflammation is or has been present.
