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Heel spur surgery is a surgery performed to address a heel spur and the underlying causes of the outgrowth of bone around the heel. What happens during the surgery varies, depending on the location of the spur and its cause. The surgery can be performed by a foot specialist such as an orthopedic surgeon or podiatric surgeon, and recovery times vary, with some surgeries requiring up to a year for the surgical site to fully heal.
Before heel spur surgery can be performed, the surgeon evaluates the patient to confirm that nonsurgical treatments have been attempted, and to learn more about the conditions which led to spur formation. Medical imaging studies may be ordered to get a good look at the spur and the structures in the foot. The patient will also be screened for any surgical risk factors which could complicate the procedure.
In a minimally invasive form of surgery for heel spurs known as endoscopic heel spur surgery, the physician makes small incisions around the heel to introduce cameras and tools, using the camera to see inside the heel while the surgery is performed. For this procedure, the patient may be given local anesthesia, conscious sedation, or full general anesthesia, depending on which option the anesthesiologist, surgeon, and patient feel is best.
For more invasive surgeries, general anesthesia may be required. During the surgery, the surgeon will typically cut some of the plantar fascia so that it will not pull at the heel, and the heel spur itself may be removed. The surgeon decides on removal of the spur based on the location; if the patient does not walk on the spur, removal may not actually be beneficial. When the surgery is over, the patient is given pain management drugs and monitored for several hours before release to confirm that the surgery has not caused any immediate complications.
For about a week after surgery, the patient will need to keep weight entirely off the foot. The foot may be in a bandage, cast, or special boot. After the first week, the patient can usually wash the foot and place light loads on it. It's important to be gradual about reintroducing weight to the foot after surgery, as too much strain can injure the foot. For people with sedentary jobs, it's usually possible to return to work right away. People who stay on their feet for extended periods may need six to eight weeks off, and people who do heavy labor will need at least three months.
It can take up to a year for all of the structures inside the foot to recover from heel spur surgery. During this period, the patient should plan on follow up visits with the doctor to examine the heel and make recommendations to reduce the risk that the spur will form again. Some patients also benefit from physical therapy.
Heel spurs are a huge problem for some joggers. The best way to deal with them is not to get them in the first place. That means investing in good running shoes, learning when to rest and knowing your limits are critical. The worst thing a runner can do to deal with heel spurs (a result of the dreaded plantar fasciitis) is to simply ignore them and choose to "push through" the pain.