SmartHallux® Method
Smarthallux explains to you
All you need to know
on the heel spur
What does heel spur mean?
Heel spur is a condition that causes heel pain, often related to excessive pronation of the foot and repetitive strain on the plantar ligament. Surgery is one of the treatment options for heel spurs when conservative treatments have failed.
Plantar fasciitis, also known as heel spur, is a fairly common condition among athletes and non-athletes over the age of 45. It is characterized by pain in the sole of the foot, sometimes radiating to the entire heel, and is especially noticeable when weight-bearing.
It is a pathology that often involves both feet, although the symptoms often involve the dominant limb first.
Heel Spur: What are the symptoms?
The symptoms that the patient suffering from heel spur reports most frequently are:
• Pain in the heel, especially in the morning or after a period of rest.
• Sensitivity to touch on the underside of the heel.
• Rigidity
• Pain radiating along the arch of the foot.
The cause of plantar fasciitis is related to a progressive loss of elasticity, resulting in shortening of the Achilles tendon and triceps surae. This muscle-tendon complex puts tension on the plantar fascia, which, over time, can become painful. Repetitive microtrauma associated with sports activities such as running or jumping can also contribute to the onset of symptoms.
Other causes of heel spurs are:
• High impact activities.
• Inappropriate footwear.
• Overweight or obesity.
• Some medical conditions.
Patients often come to the doctor after an X-ray showing the appearance of a so-called "heel spur." It has now been widely demonstrated that this "spur" is not the cause of the problem but merely a consequence of chronic inflammation.
Patients suffering from plantar fasciitis or heel spurs often experience pain in the lower part of the posterior process of the calcaneus or heel, or even radiating posteriorly, which occurs when the patient puts his foot on the ground, often in the morning during the first steps.
When plantar fasciitis occurs, the first approach is conservative.
Heel Spur: Non-Surgical Treatments
Non-surgical treatment for heel spurs includes:
• Rest.
• Ice.
• Painkillers.
• Physiotherapy.
• Orthoses.
• Cortisone injections (can lead to rupture of the plantar fascia)
To reduce the inflammation of plantar fasciitis, rest, anti-inflammatory medications, and some physical therapies can often resolve the problem. The goal of these therapies should not be to eliminate the thorn, which isn't the cause of the problem, but rather to reduce inflammation and muscle tension.
Orthotics, or insoles, can be effective during peak inflammation to reduce tension in the triceps surae and Achilles tendon, but in the long run they further shorten the tendon and can therefore worsen the cause.
When conservative therapies are not effective, one can consider resorting to surgery, which represents a simple and, above all, long-lasting solution.
Diagnosis of Heel Spur
A specialist visit is essential to make a diagnosis.
The specialist, simply by observing the patient walking barefoot and performing some tests, is able to reach a diagnosis.
To decide on the patient's treatment plan, the doctor uses a weight-bearing foot X-ray. This is an examination performed with the patient standing, because the foot works while standing and the condition manifests itself while standing. Ultrasound to diagnose heel spurs, magnetic resonance imaging (MRI), and computed tomography (CT) are second-level tests, useful in certain situations, but they often provide the surgeon with less information than X-rays, as they are performed with the patient lying down.
When to consider heel spur surgery?
• If non-surgical treatments have been unsuccessful.
• If the pain is severe and interferes with daily activities.
Advantages and disadvantages of heel spur surgery-
Advantages:
• Resolves the pain problem effectively and lastingly
• Improves foot function, particularly ankle mobility and Achilles tendon elasticity
• Can prevent further damage
Disadvantages:
• Requires a recovery period.
• There is a risk of complications, although rare
• It may not be effective for everyone if performed with incorrect technique and instructions
The goal of SmartHallux
The goal of SmartHallux is to revolutionize the treatment of plantar fasciitis and guarantee you a safe, reliable and above all long-lasting solution.
To achieve this goal, we adopt the best surgical techniques for heel spurs, orthopedic devices, instruments and materials available on the market.
Heel Spur: Surgery
Anesthesia
The anesthesia we use at SmartHallux does not involve painful ankle injections or uncomfortable spinal anesthesia or general anesthesia.
Using ultrasound guidance, our anesthesiologists are able to identify the nerves and, with a single puncture behind the knee, selectively "numb" the nerve structures necessary and sufficient to perform the procedure painlessly, leaving the patient with full mobility of the legs and bladder control. Sedation allows the patient to avoid anxiety and, often, to wake up immediately after the surgery.
This type of anesthesia also allows for anesthesia to be prolonged for up to 24-48 hours, reducing or even eliminating post-operative pain, without any risks or contraindications.
Heel Spur: Surgical Technique
Traditionally, surgery for plantar fasciitis was based on sectioning the plantar fascia using a mini-open or minimally invasive technique and removing the heel spur.
In recent years, however, advances in biomechanical knowledge have allowed us to develop interventions that are less incisive and, above all, lead to much earlier recovery.
At SmartHallux, we don't perform the traditional incision under the sole of the foot, which, due to post-operative pain, prevents the patient from putting weight on their foot and wearing normal shoes for several weeks. Instead, we make a small incision behind the knee, which lengthens the gastrocnemius muscle, reducing tension in the plantar fascia and thus eliminating pain.
Duration of the intervention
The operation is generally performed in day surgery. The patient enters the hospital in the morning and returns home the same evening.
Back to activities
The day after surgery, once sensation is fully restored, the patient can walk with full support of the foot, wearing any shoe. They can immediately return to driving without any risk or limitation.
The first check-up is performed approximately 15 days after surgery to remove the stitches. Full recovery generally occurs one month after surgery. The patient can return to contact sports after 3-4 weeks. Rehabilitation involves only the introduction of a simple stretching exercise to keep the gastrocnemius and soleus muscles supple.
Why choose SmartHallux for surgery?
Dr. Luigi Manzi, an orthopedic surgeon specializing in foot and ankle surgery and responsible for SmartHallux in Italy, offers an innovative, minimally invasive treatment for heel spurs.
His technique, combined with collaboration with selected clinics, allows for excellent results at a competitive price.
SmartHallux® Certified Clinics
FAQ
As with any surgical procedure, there are some risks associated with heel spur surgery. These risks, although very rare, include infection, bleeding, and deep vein thrombosis. Minimally invasive heel spur surgery reduces the risk of these complications.
