Heel Bone spurs

[D M]

I'm off trail from the PCT trying to recover from foot pain from an 8mm bone spur. My therapy is to start next Monday and go for two weeks. While I am getting less pain now, resting and vitamin "I" per doctors orders and I may be getting an orthotic, I am doubtful about my possible return to the trail this year. Has anyone here experience with managing heel bone spurs?

[Ian]

I had some serious heel pain a couple/few years ago. Doc in the box took a couple x-rays and we saw that I have some medieval looking heel spurs; not sure of the size but it was/is big and nasty looking. He referred me to a podiatrist and warned me that surgery may be necessary. All this made sense as the pain in my heel radiated from where the heel spur was located.

Took my Xrays to a podiatrist and described my symptoms to him. He confirmed that I did indeed have heel spurs but told me that wasn't what was hurting me. It turned out that my pain was from plantar fasciitis.

Long story short, new insoles for my shoes and I was back to normal in no time flat. Three or so years later, bone spur is still there and isn't bothering me.

I give you this lengthy story as some background before I ask my next question, were you diagnosed by a podiatrist or a GP?

[matt brisbin]

Because Plantar Fasciitis was mentioned I thought I'd chime in with something that greatly sped up my recovery after getting plantar fasciitis on the jmt.

The Strassburg sock:
http://thesock.com
http://www.amazon.com/Strassburg-Sock-Regular-Size-Around/dp/B001AW3O00

While it's a bit uncomfortable on the toes it worked wonders in getting me back to shape if you do find out you have plantar fasciitis. If I ever do something longer like the PCT I may just take this sucker with me (of course making it lighter… this is BPL after all :-))

[Pedestrian]

Please see the following – from another pedestrian oriented forum….

A lot of misdiagnosis and over treatment with steroids, surgery, etc etc

Caveat emptor!!!!

And of course, caveat lector.

---

An interesting video I came across was of a doctor discussing plantar fasciitis and the possibility it is actually plantar fasciosis (ie necrosis of the plantar fascia). The argument sounds plausible.
http://youtu.be/7rin6PzWQCs

Anyway, what I found most helpful was a listing on their website of naturally shaped footwear. Most relevant is that Altra's made the list as well as Merrell's and Inov-8's… though I think we already knew that.
https://correcttoes.com/resources/111-Shoe%20List

[Bob Gross]

It is always fascinating to me that people find so much of their medical advice online at some site that is advertising medical devices that you need. It seems like a conflict of interest.

I had a bad foot problem last year, and from the location of it, I assumed that it was something like a stress fracture of the heel, or something like that. After I limped around with it for a couple of months, a friend suggested that it might be plantar fasciitis. The more I thought about it, the more sense that made. So, I started standard home treatment for PF, and that finally knocked it out a few months later. The treatment was to walk daily, then immediately to roll the foot over a frozen metal bottle of ice for 15 minutes. Naturally, I used an aluminum beer bottle.

–B.G.–

[Pedestrian]

BG feels compelled to weigh in on "internet medical advice"……as everything else.

If you know not what you speak of please don't feel the urge to comment. You really don't need to comment on every thread!!!

Please check out the posted video before you blow more hot air…..

[D M]

My injury was examined by a very good Family Practitioner in Lake Tahoe that my family has had for years and the doc treats olympic level skiers and other athletes. Then she ordered the X-ray and my family recommended the Physical Therapist who is also treating many higher level athletes, plus a relative (with success) whom live in the Tahoe area. I agreed readily to stay and take the diagnosis and therapy because I have had PF before and believed I had beat it, when in fact I apparently did not. But I didn't know I have this bone spur until now. The heavy water carries are what I believe led to the problem, I trained hard with my full pack for over a year and had no issues. Legs are great, lungs are fine and I made it to Kennedy but the pain in my foot forced me to reduce my mileage considerably the last week. I appreciate all of your input, thank you! With therapy and rest and an orthotic I may be able to get back on trail.
Pedestrian: I can't wear Altras they hurt my anklebone, and Merrels heel cup was too sharp on the front edge for me and Innnov *'s too narrow, believe me Ive tried tons of shoes and it's always a constant hunt for the best shoe, but the insert is more key for me at this point.

[Ian]

Ok good luck and godspeed.

[Jennifer Mitol]

Seriously.

The bone spur is the RESULT of the aberrant stresses that are put through whatever is pulling at the bone – the bone spur itself, in the vast majority of cases, does not itself hurt nor is it the CAUSE of any pain. If it's poking something important, like your spinal cord, well, then that's a different story.

If your bone spur is located underneath your heel, pointing towards your toes, it is the reaction of your calcaneus (your heel bone) to lay down more bone along the insertion of the connective tissue (in the case I mentioned, your plantar fascia) in order to try to stop it from pulling away from the bone itself.

The previous poster is correct in that there is no inflammation in plantar fasciitis. Or in any tendon problem, actually. It is a degeneration and disorganization of the tendon or connective tissue, and because of a serious lack of blood supply, it is slow to heal (if it ever does). Injecting these things with a corticosteroid does NOTHING in terms of healing – you may feel great for about 6 months, then you'll either get better because it was going to get better anyway, or (and this is the most common response) you'll actually get much worse than you were before.

And for the love of all things holy, will you people STOP getting things x-rayed and MRI'd???!!!!! You cannot see pain on any image. You can see structural changes, but those IN NO WAY correlate with pain. Unless you just stepped off the curb and broke your ankle, an x-ray will give the MD absolutely NO information whatsoever. Yep – you've got a bone spur. So do about 75% of people who have their feet x-rayed, whether they have pain or not. A bulging disc? Yep – about 60% of people who have never had back pain have bulging discs. Arthritis? Of course. 100% of the population over the age of 50 has it…and the vast majority of them don't even hurt.

Why do doctors tell you these things? Because a) it's all they know how to do, b) there is very little knowledge of pain science outside of certain specialities, and c) they make their money by injecting you with steroids, cutting out bone spurs and sewing up rotator cuff tears and snipping menisci in knees and fusing spines.

Sorry. I've had a really long day, and if one more person comes to me saying they have a "bulging disc" and that's why their back hurts I'm going to strangle someone. Probably Doug, just for fun. I'm sure he deserves it for something anyway.

[Jennifer Mitol]

Drusilla,

Sorry about my rant, but every now and then I have to do that. At some point I'll educate enough people to be good medical consumers….

As for your foot – since you say you've had PF in the past…keep up with the PT and make sure the therapist actually feels how the bones move in your foot and ankle. If all they have you do is exercises it isn't enough. A good PT needs to put his/her hands on you, feel the bones and how they interact with each other, move the ones that are tight and stabilize the ones that are loose.

I wish you good luck – and feel free to email me with any questions you've got. It sounds like you are in good hands, but PLEASE don't take the heel spur to mean anything serious. I've got two massive ones in my feet (found after I broke my ankle in February) but my feet don't hurt now, have never hurt before, and feel great.

There is a ton of evidence emerging that if people think there is a massive structural deficit that is the cause of their pain (whether it is or it isn't…) then their recovery is much poorer than those who either didn't have any imaging done in the first place, or who understand that the structural deficit does not necessarily = pain.

[Ian]

Two things I've learned here today…

1. Bone spurs do not hurt
2. If you get an X ray, Jennifer will come at you like a spider monkey and punch you in the throat.

[Steven Paris]

That makes me want to get an x-ray of my throat.

[Ken Thompson]

Jennifer. Do you need a ride over to Doug's place?

[Ian]

"Jennifer. Do you need a ride over to Doug's place?"

It's only 1492 miles so if you chug a six pack of Red Bull and start now and average 65mph and stop for 10 minutes once every 350 miles for gas and do it like that lady did from NASA and wear an adult diaper while you're driving you should be there in roughly 23 hours 45 minutes.

[BlackHatGuy]

"I'm going to strangle someone. Probably Doug, just for fun."

Great, then I'll have to go to my doc and he'll probably order some x-rays…..

Since we're on the subject of ultrasounds (is there white spittle and froth coming from Jen yet?), remind me to tell you the story about my ultrasound. I couldn't have had a better time in Vegas, and only 12 bucks! I love the American health care system.

No where did I put that throttle guard…..

[Ken Thompson]

Van has a queen size bed, curtains and a porta potty. Can fill up in less than ten. But need to stop for fuel more often with the brick like aerodynamics.

[BlackHatGuy]

"Van has a queen size bed, curtains and a porta potty. Can fill up in less than ten. But need to stop for fuel more often with the brick like aerodynamics."

My second wife's father had a brother he hadn't seen in a long time, so he decided to visit. He lived in Richmond, Virginia. His brother lived in Anchorage, Alaska. So he packed up his van with a porta potty and provisions and he and a friend drove from Richmond to Anchorage to visit his brother.

I am not making any of this up.

My second wife's father was not really a very social man. So he and his friend had dinner with his brother after arriving. The next morning, early, they packed up the van and drove back home.

[Ken Thompson]

Dinner is not necessary. I'm just there for the choking. I'll keep the engine running.

[D M]

Jen I get it, thanks! :-) Your input is greatly valued by me. I got the x ray because I wanted to rule out a possible fractured foot, it was quite painful. Obviously my pain is soft tissue damage of some kind. Especially since Ibu and rest has helped immensely since I got off trail. I will make sure the PT person does as you have recommended. I would be surprised if he didn't do that anyways as he is very good. It went like this: My average milage from Campo was 12 to 15 miles a day with a few 19 milers on easy going, and I deliberately took it easy most of the time although I had days where I had to push the milage due to the water issue and as you may know the heavy water carries from the start have been really tough, especially in a drought year and then caches being eliminated or no longer maintained. So being forced to carry six to eight liters, sometimes less has complicated things to say the least. If you go slower/less milage you have to carry more water and food. If you go faster you risk injury. And I factored in plenty of rest days. REALLY folks the reality in this type of trip is that all the BPLing in the world won't save you from food and water weight in a year like this, its been tough for EVERYONE. We all have the same horrendous blisters and leg problems, no one I've met is unscathed. I did everything I could to eliminate weight and just survive on the basics and remain at a lower milage to reduce the possibility of injury. My pain actually manifested during a rest day, a small twinge in my inside heel, but we get lots of pains that can be walked through so I got back on the trail and gradually over four days did less and less milage due to increasing pain until I could no longer do more than 5 miles a day and that is where I stopped at a cold creek and a road. My foot was on FIRE! When the injury did not get better in two days I started rationing my food in preparation for staying longer and resting but my family whom I am in contact with with the InReach insisted that I get out and get to a doctor, which I did. So my appointment with the PT is next Monday, and till then it's rest and ice and prescription ibuprophin and a lot of hope that I can get back on the trail.

[BlackHatGuy]

"So my appointment with the PT is next Monday"

You're going to a PT? Oh man, that's too bad. Your foot will have to be facing backward or only hanging by a tendon (do feet have tendons?) before they'll recommend an x-ray. And even then they can't help but say 'x-ray' in a really snide way. Testy lot, those PTs.

[Nick Gatel]

Drusilla –

No advice from me unless you need a car fixed.

Hope you get well soon and can finish you hike.

Good luck!

[D M]

Thanks Nick! PCT is AWESOME, I love it. The views, the people, the flowers, and the people are the best, so kind and generous. It's been a great hike despite the blisters and water problems and my owie. If I can't continue this year there's always next year.

[Stuart R]

I have a heel spur. I think it grew over many years, when I was younger. The only time it caused me any pain was when I had some badly fitting winter mountaineering boots. I was offered surgery but declined. Since I discarded those boots and got some new ones that fit better, I have had no trouble at all.
Your symptoms sound very different.

[Jennifer Mitol]

Apparently I'm feeling awfully chaffy lately.
But I'm sure Doug still needs to be strangled.

Who's got the van i can borrow?

[Mark Ries]

If you offer to meet up with Doug for sex he will come your way that way he doe's the major driving

[Author]

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