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Heel Spur on back of Heel that is scraping the Achilles Tendon

Posted by David Graves on 4/02/02 at 00:37 (078229)

Dear Doctors:

I have been in severe pain for 2 years with this Heel Spur and can't take it anymore. It is on the back side of my right heel and scrapes the Achilles Tendon with every step. What I want to know is , what non-surgical treatments will eliminate my heel spur? Any suggestions or ideas will be greatly appreciated.

Sincerely,

David Graves

Re: Heel Spur on back of Heel that is scraping the Achilles Tendon

Dr. David S. Wander on 4/02/02 at 07:52 (078237)

David,

There are no non-surgical methonds to actually eliminate the spurring that you have at the back of the heel. Often these spurs are actually calcifications within the substance of the tendon. If there is pain in the area with simply moving your ankle (with no shoes on), this would indicate that surgery may be the solution. If the Achilles tendon is tight, sometimes stretching exercises will help eliminate some of the discomfort. If there is simply irritation from shoe pressure, the solution is more simple. Often the back of the shoe presses on the bony prominence which in turn irritates the tendon and surrounding tissues. If this is the case, there are excellent products made by a company called Silipos. These products utilize a silicone gel material to cushion the area. Your best bet would be to seek a professional opinion regarding the actual cause of your pain, to be able to successfully begin treatment.

Re: Heel Spur on back of Heel that is scraping the Achilles Tendon

Dr. Zuckerman on 4/02/02 at 08:24 (078241)

Here is a list of treatments for your problem.

1. Gel padding
2. Physical Therapy
3. NSAID
4. Heel lifts and or orthosis if there is a biomechanical problem
5. ESWT : This is the non-surgical procedure which is very effective for a chronic insertional achilles tendon
6. Surgery.

Re: Heel Spur on back of Heel that is scraping the Achilles Tendon

Ed Davis, DPM on 4/03/02 at 21:51 (078429)

I will try to be the tie breaker since you got two differing opinions.

If the 'spur' is relatively small, without a lot of calcification in the achilles I would lean toward ESWT but if the spur is significant in size with a lot of calcified tendon, I would favor the surgical route.
Ed

Re: Heel Spur on back of Heel that is scraping the Achilles Tendon

Dr. Zuckerman on 4/03/02 at 21:55 (078432)

Just to add some of my observations . I have cured small spurs and extremely large spurs associated with insertional achilles tendonitis. In my experience the size hasn't nothing to do with the choice of ESWT. Just my observation of ESWT and Insertional achilles tendonitis with or without any calication

Re: Heel Spur on back of Heel that is scraping the Achilles Tendon

Dr. David S. Wander on 4/04/02 at 08:28 (078464)

Dr. Ed, Dr. Z,....In my original response, I stated that there is no way to GET RID of the spur non-surgically. Obviously there are dozens of methods of reducing symptoms, but there is no way to get rid of the retrocalcaneal spur without surgical intervention.

Re: Heel Spur on back of Heel that is scraping the Achilles Tendon

Dr. David S. Wander on 4/02/02 at 07:52 (078237)

David,

There are no non-surgical methonds to actually eliminate the spurring that you have at the back of the heel. Often these spurs are actually calcifications within the substance of the tendon. If there is pain in the area with simply moving your ankle (with no shoes on), this would indicate that surgery may be the solution. If the Achilles tendon is tight, sometimes stretching exercises will help eliminate some of the discomfort. If there is simply irritation from shoe pressure, the solution is more simple. Often the back of the shoe presses on the bony prominence which in turn irritates the tendon and surrounding tissues. If this is the case, there are excellent products made by a company called Silipos. These products utilize a silicone gel material to cushion the area. Your best bet would be to seek a professional opinion regarding the actual cause of your pain, to be able to successfully begin treatment.

Re: Heel Spur on back of Heel that is scraping the Achilles Tendon

Dr. Zuckerman on 4/02/02 at 08:24 (078241)

Here is a list of treatments for your problem.

1. Gel padding
2. Physical Therapy
3. NSAID
4. Heel lifts and or orthosis if there is a biomechanical problem
5. ESWT : This is the non-surgical procedure which is very effective for a chronic insertional achilles tendon
6. Surgery.

Re: Heel Spur on back of Heel that is scraping the Achilles Tendon

Ed Davis, DPM on 4/03/02 at 21:51 (078429)

I will try to be the tie breaker since you got two differing opinions.

If the 'spur' is relatively small, without a lot of calcification in the achilles I would lean toward ESWT but if the spur is significant in size with a lot of calcified tendon, I would favor the surgical route.
Ed

Re: Heel Spur on back of Heel that is scraping the Achilles Tendon

Dr. Zuckerman on 4/03/02 at 21:55 (078432)

Just to add some of my observations . I have cured small spurs and extremely large spurs associated with insertional achilles tendonitis. In my experience the size hasn't nothing to do with the choice of ESWT. Just my observation of ESWT and Insertional achilles tendonitis with or without any calication

Re: Heel Spur on back of Heel that is scraping the Achilles Tendon

Dr. David S. Wander on 4/04/02 at 08:28 (078464)

Dr. Ed, Dr. Z,....In my original response, I stated that there is no way to GET RID of the spur non-surgically. Obviously there are dozens of methods of reducing symptoms, but there is no way to get rid of the retrocalcaneal spur without surgical intervention.