Heel Spur Surgery

Sometimes, you can treat bone spurs in your heel with rest and physical therapy. However, if the spurs are causing you pain and limiting your mobility, your podiatrist can perform minimally invasive surgery directly in their office. Trust Dr. Velimir Petkov of Premier Podiatry in Clifton to recommend the best treatment for you. If you require surgery, Dr. Petkov can help you get back on your feet. Call today.

Heel spurs are bony growths that usually start at the front of your heel bone and grow toward your arch. Anyone who has received treatment for plantar fasciitis often experiences heel spurs as well.

You may not experience any heel pain due to your spurs, so you may be unaware of their presence unless you are being treated for another condition. If you have heel spurs in addition to other foot problems, your pain may be severe enough to warrant heel spur surgery. However, because most people respond well to non-invasive treatment, surgery is now only used as a last option if the more conservative treatments do not work.

Causes and Risk Factors

Heel spurs occur when the ligaments and muscles of the foot are strained and lengthened, tearing away at the lining that covers the heel bone. You may be at greater risk for developing heel spurs if you:

• Already suffer from plantar fasciitis or arthritis
• Are a runner or a jogger, especially if you consistently run on hard surfaces
• Have certain biochemical imbalances
• Carry excess weight, since it puts a heavier burden on your feet
• Wear improperly fitting shoes

Generalized or localized heel pain can be caused by a number of conditions, including arthritis, tendonitis, a fracture, nerve irritation, and, in rare cases, a cyst. You should see one of the best-rated foot doctors in New Jersey, Dr. Velimir Petkov, for a thorough examination. Dr. Petkov may use digital x-rays to determine the exact nature of your heel pain in order to achieve a conclusive diagnosis.

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Symptoms Requiring a Doctor Visit

It’s normal to get the occasional bruise, strain, or discomfort in your feet. Most foot injuries may only require rest and at-home remedies. But do visit our foot doctor in Clifton, NJ at Premier Podiatry if you experience consistent pain that lasts longer than a couple of weeks.

Of course, if your pain is interfering with your daily activities, you should see a foot specialist as soon as possible. The sooner you treat foot disorders, the higher are your chances of complete recovery with fewer complications. Seek medical care right away if you see any signs of infection alongside your heel pain. Symptoms of an infection include redness, swelling, and heat at the site of the pain or fever.

Heel Spur Diagnosis

The doctor will conduct a thorough podiatric physical examination and a meticulous evaluation of your symptoms to properly diagnose your problem. Diagnostic studies, such as X-rays, may be used to examine the bony structures of your foot during this comprehensive evaluation.

Your gait and stance may also be assessed to see if misalignment of your hips, knees, and ankles is affecting or resulting in your heel pain. Your workout routines, the sort of shoes you wear, and any medical disorders that could be causing your heel discomfort could all be looked into.

Non-Surgical Treatments for Heel Spurs

Your podiatrist in New Jersey will always start your treatment with the most conservative, non-invasive options. However, persistent heel pain or a deformity signals that surgical intervention is required. Non-surgical options include:

• Stretching exercises to relieve tension;
• Ice, rest and limiting activities;
• Always wearing shoes that are properly supportive;
• Non-steroidal anti-inflammatory medications (NSAIDs);
• Compression through padding or taping;
• Custom orthotic devices in your shoes;
• Walking boots or casts;
• Injection therapy with corticosteroid injections;
• Night splints;
• Physical therapy.

Contraindications

While non-surgical treatment is effective for the vast majority of plantar fasciitis patients, a small percentage of people may require surgery. If your heel pain persists after several months of non-surgical treatment, surgery will be considered. Contraindications for surgical treatment include:

• An active infection;
• Overall poor health;
• Bleeding disorders;
• Compromised vascular function;
• Impaired skin integrity.

Purpose of Heel Spur Surgery

Plantar fasciitis can be surgically treated if non-operative procedures fail to relieve the symptoms. Your surgeon will require you to have failed at least 9 months of conservative treatments prior to surgery.

All plantar fasciitis surgeries entail a surgical lengthening of the plantar fascia ligament. The secondary decision is whether to remove the bone spur, which is determined by its size, location, and orientation (forward or downward), as well as the existence of a fracture and/or your symptoms.

Pre-Operative Evaluation

Surgery may be recommended if heel spurs coexist with severe plantar fasciitis or Achilles tendonitis. Before considering heel spur surgery, your doctor will usually conduct a differential diagnosis to rule out other potential culprits, such as bone tumors, bursitis, and rheumatoid arthritis.

Heel Spur Surgery Options

When all other treatment options have been exhausted, your podiatrist may recommend you to undergo minimally invasive endoscopic heel spur surgery. The type of surgery depends on your diagnosis and overall medical health, but the goals include pain relief and mobility restoration. Among the options are:

• Surgical treatment of your plantar fasciitis with a surgery called plantar fasciotomy, which releases the plantar tissue from your heel bone. The technique involves two small incisions on either side of the heel, through which your doctor inserts an endoscope and a small surgical hook to remove the portion of the fascia.
• Endoscopic heel spur resection, which removes small pieces of the bone spur through a small incision. In this procedure, a small incision is made on the side of the heel, through which a small cannula is placed, allowing an arthroscopic camera to be inserted. A tiny surgical blade is then used to remove the plantar fascial ligament.
• Open heel spur resection surgery, which removes the entire bone spur. This type of surgery entails your surgeon cutting the area with a scalpel and completing the procedure through a large incision.

Many podiatrists in New Jersey perform both surgeries — a plantar fasciotomy and an endoscopic heel spur resection — at the same time. Because it is more invasive, open-heel surgery is rarely used and is reserved for severe cases. The more invasive the surgery, the longer your recovery time.

Endoscopic Heel Spur Surgery

After you’re given the appropriate anesthesia, Dr. Petkov makes a small incision in the side of your heel. Through this small opening, he inserts an arthroscopic camera and scalpel. Using the imaging, he detaches some of the plantar fascial ligament from the bone and removes some or all of the heel spur.

This outpatient procedure takes place right in the Premier Podiatry office. You’re sent home in a post-operative cast. Unless you’ve had general anesthesia, you can drive and walk, but your podiatrist recommends limiting your walking to give your heel time to heal.

How to Prepare

Location

In most cases, the surgery is done in an outpatient surgical center or a hospital operating room. Local anesthesia, twilight anesthesia, or general anesthesia can all be used. Standard surgical equipment, such as an anesthesia machine, surgical table, an electrocardiogram (ECG) machine to monitor your heart rate, and a mechanical ventilator to provide supplemental oxygen if needed, will be at the site.

What to Wear

Your foot may be bandaged, put in an ankle splint or walking boot, or covered in a cast, depending on the extent and location of the surgery. Wear baggy shorts or loose-fitting pants that can easily slip over your foot to compensate for this.

You’ll be requested to remove your contacts, hairpieces, dentures, hearing aids, and tongue or lip piercings before the procedure. Jewelry and watches, in particular, should also be left at home.

Food and Drink

The night ahead of your surgery, you will be recommended to stop eating at 12 a.m. You can take your morning meds with a few modest sips of water the morning of the procedure. You should not eat or drink anything for four hours after surgery. Follow the recommendations for when to stop eating and drinking to the letter. Your surgery may be rescheduled if you don’t adhere to the doctor’s instructions.

Medications

Your doctor will recommend you discontinue medications that cause bleeding and hinder wound healing for one day to two weeks before surgery. You may also be advised to stop taking these medications for a few weeks after the treatment.

The following are some of the medications that should be avoided before surgery:

• Aspirin;
• Plavix (clopidogrel);
• Ibuprofen (Advil, Motrin);
• Naprosyn (Aleve);
• Celebrex (celecoxib);
• Mobic (meloxicam);
• Coumadin (warfarin);
• Over-the-counter herbs like garlic tablets, quilinggao, and feverfew.

What to Bring

You’ll need your driver’s license (or another form of government identification), your insurance card, and an accepted form of payment if you have to pay a copay or coinsurance cost upfront. (Be careful to contact ahead to confirm that the office accepts your insurance and is an in-network provider). You’ll also need someone to take you home and, preferably, look after you for a few days and keep an eye out for any complications.

What to Expect on the Day of Surgery

Based on the complexity of the procedure, an anesthesiologist, operating nurse, endoscopic technician, and surgical technologist may accompany your orthopedic surgeon.

Before the Surgery

You will be registered and given medical information forms to fill out when you arrive at our practice. You will be brought to the back to change into a hospital gown after signing consent forms indicating that you understand the purpose and risks of the procedure. Your weight, height, vital signs, and blood sample will be taken by a nurse. To administer medicines or fluids, an intravenous (IV) line will be inserted into your vein. A pulse oximeter will be clamped to your finger to monitor your blood oxygen levels, and EGC leads will be placed on your chest to track your heart rate.

During the Surgery

Your anesthetic provider may put you to sleep or simply numb the area that has to be worked on. You will also be given medication to help you forget about the procedure. The surgeon marks the surgical site, cleans your foot, and performs the surgery, which usually takes 1 to 2 hours.

After the Surgery

You’ll be taken into recovery after the procedure and supervised by a nurse until the anesthesia wears off. Heel spur surgery is normally performed as an outpatient procedure, meaning you can return home the same day as your treatment. Following this surgery, many patients wear splints or boots. These devices are used to stabilize your foot and also aid in the healing of your plantar fascia. You can begin putting your normal weight on your foot within a few weeks. In around 12 weeks, your foot should be completely healed.

Recovery Period

Plantar fasciitis surgery can take up to six weeks to recover from, and healing after bone spur removal can take up to three months. To facilitate proper healing, your surgeon will provide you with thorough instructions on how to care for your foot. The general guidelines provided by your doctor after the heel spur surgery may include:

• Staying off your feet as much as possible during the first week of recovery
• Use of over-the-counter pain relievers to help with minor aches and discomfort
• The RICE approach soon after surgery to reduce pain and swelling
• Wearing bandages and wraps to achieve compression
• Reducing swelling by elevating the surgically treated foot (preferably above the heart)

The time off work is determined by your job’s demands as well as the sort of footwear you must wear. If the profession only requires a small amount of walking and you’re able to wear a cast while working, you may be able to return to work within a week. You may be forced to stay off work for three weeks or longer if the job requires you to walk, stand, kneel, or climb a lot.

Possible Complications

The surgery has a remarkably high success rate overall. However, like with any major treatment, there are associated complications, including:

• Recurrent heel pain
• Damaged weakened soft tissues in the area of the heel
• Infection in the surgical site
• A pinched or damaged nerve called a calcaneal neuroma
• Permanent loss of sensation in the area

Preventing Heel Bone Spur Surgery

The best way to avoid heel spurs is to change your lifestyle. Consider the following tips:

• Losing weight if you’re obese
• Wearing the correct shoes for each activity
• Wearing shoes that fit properly and have shock-absorbent soles and a supportive heel
• Wearing flats and not high heels
• Stretching your calves, ankles and feet before activities
• Pacing yourself during athletic exercises and throughout your daily routine
• Getting the appropriate amount of rest and nutrition so your body can rebuild fatigued muscles

Heel Spur Surgery Cost

Heel spur surgery is usually covered by health insurance. Out-of-pocket costs for insured individuals typically include a specialist copay, a hospital copay of $100 or more, and coinsurance of 10% – 50% for the treatment. For non-insured patients, surgically removing a bone spur costs between $5,000 and $10,000, depending on the complexity. The cost of surgery commonly includes the cost of the operating facility as well as the fees of the anesthesiologist and surgeon.

While common and sometimes uncomfortable, heel spurs don’t have to be painful or disruptive. Contact Dr. Petkov at Premier Podiatry in Clifton, NJ about the best treatment options for your heel spurs.

Premier Podiatry: Velimir Petkov, DPM

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