Heel spur laser treatment

Heel spurs, also known as plantar fasciitis, are considered one of the most popular "diseases" of people over forty years old. This disease is unpleasant because it causes acute pain with any load on the heel. The cause of these pains is considered to be a bone growth behind the foot at the junction of the heel bone and tendons. Laser treatment of heel spurs is one of the popular methods of treating this disease, which involves either relieving inflammation and pain with a small size of bone formation, or removing calcification with a laser beam of regulated power.

A little about the disease itself

Legs are a part of the human body that experiences enormous stress every day, because the lower limbs are subject to the weight of the body plus the heavy objects we carry. It is not surprising that at some point we may experience pain in the legs. But this pain can be different, and by its nature we can understand the reason for the appearance of such an unpleasant symptom.

If we are talking about a burning piercing pain behind the foot when walking or any load on the heel, then most likely it is associated with a heel spur. Where does such pain in the heel area come from?

Plantar fasciitis, as the name suggests, is an inflammatory disease of the foot, in which inflammation of the aponeurosis that supports its longitudinal arch occurs. At the site of inflammation in the area of the calcaneal tubercle, a bone growth may form, ranging in size from a few millimeters to 1.2 cm. It usually has a wedge shape and its sharp end irritates the adjacent tissues, which is why acute pain in the heel occurs.

But a heel spur is already a consequence of an inflammatory process. And the inflammation itself does not occur without a reason. As for the cause of inflammation of the plantar fascia, most often it lies in severe tissue overstrain, which causes microtraumas (microscopic ligament tears). If the load is irregular, microcracks heal quickly and painlessly. But with constant loads, the fascia tissue and nearby soft tissues can become inflamed without the possibility of recovery, because regular excessive loads on the foot do not allow them to recover.

At the site of long-term internal inflammation, the metabolism in the tissues is disrupted, resulting in the deposition of calcium salts in this area. A small spur can be detected on an X-ray even when a person does not yet experience pain when pressing on the heel. As the spur grows, pain appears, which intensifies over time, and the inflammatory process spreads further to the foot.

Where does excessive load on the heel come from? Most often, flat feet lead to incorrect distribution of load on different areas of the foot. With this pathology, the tendons on the spot are constantly under strong tension and any impact on them (for example, a person stepped on a bump or a pebble) can lead to the appearance of microscopic ruptures. Even if this rupture is scarred, in the future, under pressure, the scar can diverge again and become inflamed.

Why are heel spurs more common in people over 40? The reason lies in age-related changes, because over time, regenerative processes in our body become worse. And if we add to this the circulatory problems common to most older people, and the large loads on the foot, leading to the accumulation of scarred microdamages on it, then in older people the problem begins to acquire global proportions.

Is it possible for young people to develop heel spurs? Oddly enough, yes. This disease is typical for athletes who have a high load on the bones and ligaments of the foot. Those who are professional runners or jumpers can easily be included in the risk group for the development of fasciitis and heel spurs.

This disease is more common in women due to their addiction to high heels. And the higher the heel was in youth, the more likely it is that a heel spur will appear by the age of thirty or forty. After all, wearing heels leads to an incorrect redistribution of the load, as a result of which individual parts of the foot and ligaments experience greater load than others. Minor injuries, inflammation and bone growth occur. A visit to a doctor about heel pain leads to the appointment of treatment for heel spurs with medication, ultrasound, laser and other available methods.

When naming the causes of heel spurs, we mentioned flat feet. But this pathology is not the only one that can lead to the appearance of a growth on the foot. A large load on the legs with an increased likelihood of injury to the limbs in the area of tendons and fascia is observed in people suffering from obesity. The appearance of bone growths can be caused by metabolic disorders (diabetes or gout), injuries to the heel bone, impaired peripheral circulation due to poor vascular patency, inflammation of the joints, muscles and mucous bags in the area of the joints of the foot. A heel spur may well be an unpleasant consequence of a previously suffered serious illness.

The main symptom of a heel spur is considered to be a sharp pain in the heel when pressing on it. A person has a feeling that he has driven a large sharp splinter into his foot. As the pathology develops, the pain from short-term, arising from the load on the foot, turns into constant, which no longer requires mechanical action on the spur area. Constant pain is caused by severe inflammation of the tissues inside the heel.

It is clear that a person who cannot stand on his foot normally develops hypodynamia. Efforts to step on the sore spot as little as possible lead to a change in gait, and sometimes to foot deformation. It would seem that all the symptoms are present, and a diagnosis can be made immediately, but doctors still prefer to play it safe. An X-ray of the foot is the only way to confirm the initial diagnosis.

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How is heel spur treated?

Since any spur (both large and small) occurs against the background of inflammation and is accompanied by severe pain, its treatment is based primarily on reducing the symptoms of the inflammatory process and relieving pain in the heel. As long as the spur is small in size and does not greatly injure nearby tissues, patients get by with medication, physiotherapy, wearing corrective orthopedic shoes, massage, gymnastics for the legs, warm baths and compresses.

Drug treatment gives good results in plantar fasciitis if the spur is small. To relieve inflammation and destroy the forming bone formation, use pharmacy bile in the form of compresses (at least 20 procedures), use steroid and non-steroid anti-inflammatory drugs: dimexide, hydrocortisone, diprospan. Local treatment includes applying ointments to the area of inflammation and spur formation, which help reduce the inflammatory process and resolve neoplasms.

The simplest physiotherapeutic procedures and gymnastics are aimed at reducing pain (for example, electrophoresis with anesthetics) and inflammation, as well as improving blood circulation in the foot area, which is necessary to normalize metabolism in tissues and prevent the growth of calcium deposits.

If the spur continues to grow, it is necessary to look for other methods that can return the joy of movement to the patient. To relieve pain, drug blockades are administered, and X-ray therapy methods are used. To reduce the pathological neoplasm, shock wave therapy, ultrasound treatment, laser, magnetic field, etc., or surgical treatment are used.

The most gentle and effective instrumental methods for treating heel spurs are considered to be shock wave therapy, laser therapy and ultrasound, which can be classified as physiotherapeutic treatment.

Shock wave therapy is a targeted action of waves of a certain frequency, designed to destroy bone growths without the help of surgical intervention. The technique is used on small and medium-sized spurs. For growths less than 2 mm, it is ineffective.

Ultrasound does not help remove bone growths, it only heats the tissues in such a way as to improve blood circulation and metabolism in them, which will help reduce inflammation and activate regenerative processes. This method of treatment is suitable for small formations, but has many contraindications (pregnancy, hypotension, intoxication, acute infectious pathologies, thrombophlebitis, mental and some neurological diseases, arrhythmia, etc.).

Laser treatment of heel spurs is one of the innovative methods that has a minimum of contraindications and shows good results. In addition, it gives the opportunity to choose one of the most preferable treatment options, because depending on the frequency of laser radiation, it can either treat inflammation or remove the growth that causes painful sensations.

Indications for the procedure

Localization of inflammation (on the periphery, away from the central blood vessels), high sensitivity of the area (a large number of nerve endings on the sole), the impossibility of completely isolating the affected area from stress and damage lead to the fact that drug treatment does not always give tangible results. And even if it is possible to remove the inflammation, there is no guarantee that the disease will not return again.

Drug therapy for heel spurs is mainly local treatment with anti-inflammatory and pain-relieving ointments, gels, and creams. In order for such therapy to be effective, it is necessary to ensure easy access of external agents into the tissues, which is not so easy with rough skin on the heel. This means that in addition to regular rubbing of ointment (at least 3 times a day) and massages, you also need to steam the skin on the foot and peel it several times a day.

External use of medications and medical patches rarely gives a lasting result in itself, unless it is supported by physiotherapy procedures. The same electrophoresis with anesthetics allows for the introduction of painkillers deeper into the tissue, which significantly alleviates the pain syndrome.

One of the most effective methods of drug treatment is considered to be injections of corticosteroids into the heel joint, which allows the drug to be delivered directly to the area of inflammation. But in order for the patient to experience relief and recover, at least 2-3 such injections are necessary, during which the person has to experience severe pain, similar to the pain of removing a tooth firmly seated in a cavity without anesthesia.

Not everyone will decide on such a painful procedure if there are no less effective, but painless methods of therapy, for example, laser treatment of heel spurs.

In principle, the doctor may initially suggest this treatment option, but everything will come down to the considerable cost of the quantum therapy procedure, so laser treatment is prescribed mainly when other methods have not produced good results.

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Preparation

Laser treatment has one very important feature. It does not require long-term special preparation. In fact, an examination by a specialist doctor (surgeon, rheumatologist, orthopedist) with a standard package of tests and some instrumental studies confirming the diagnosis are already a full preparation for the procedure of treating heel spurs with a laser.

Laser therapy has few contraindications, so laboratory tests are mostly limited to clinical blood and urine tests. Additionally, blood tests for sugar and thyroid hormones may be prescribed if endocrine diseases are suspected.

A general blood test will show whether there is an acute infectious process in the body, whether the blood viscosity is impaired, and whether there are other blood diseases.

If a general blood test shows an increase in ESR and the number of leukocytes, a decrease in the number of platelets, the presence of lymphoblasts and myeloblasts against the background of a decrease in total hemoglobin, which may indicate malignant processes in the body, specific tests will be additionally prescribed to detect cancer cells.

In any case, even before prescribing the operation, the doctor will have to carefully study the patient's medical history to exclude pathologies in which laser exposure can cause harm. Special studies (even an electrocardiogram) will be prescribed if there is a suspicion of heart or respiratory diseases.

The patient will be required to have an X-ray of the foot. And not only to confirm the diagnosis, but also to determine the size, shape and location of the bone growth. This is especially important if the treatment does not give results and the spur has to be removed.

What the patient may still have to take care of is the cleanliness of the feet and the removal of hardened skin and calluses on the heel (steaming and pumice or brushing or a salon procedure). Of course, this is not an obstacle for the laser, and yet the procedure is carried out with a certain frequency of waves, which is unlikely to be adjusted to the thickness of the skin on the foot.

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Technique laser treatment for heel spurs

Laser treatment of heel spurs is a non-invasive procedure, so it does not require either total disinfection or special preparation. The requirement for clean feet is purely aesthetic and follows from hygiene rules. An additional requirement is absolute dryness of the skin on the foot.

The procedure itself does not require hospitalization. It is performed on an outpatient basis, in a room equipped with special equipment. In principle, the equipment (laser device) is portable, so there are no special requirements for the premises.

The laser therapy device is a small device consisting of a light-emitting diode with a power supply and a handle. During the procedure, the patient lies on a couch with bare feet. At this time, the doctor moves the emitter of the device along the surface of the heel, stopping at certain points, which allows for exposure in 4 projections, covering the entire area of inflammation:

• plantar part in the spur area,
• the back of the heel in the area of the Achilles tendon,
• lateral surfaces of the Achilles tendon.

The procedure lasts about 15-20 minutes, during which the person does not experience any unpleasant sensations.

Unfortunately, one procedure to reduce inflammation and relieve pain caused by heel spurs will not be enough. Moreover, a full course of laser therapy includes 10-15 such procedures performed daily.

But even this course can be limited only at the initial stage of the disease. Usually doctors recommend taking 2 or even 3 courses of laser treatment with a sequential increase in the power of the device and the frequency of pulses. The interval between courses is not less than 2 weeks.

The laser power during laser therapy does not differ much in terms of indicators and fluctuates within 80-90 mW. But the frequency indicators differ significantly. During the first course of treatment, the laser radiation frequency is minimal – 50 Hz. During the second course, the frequency is increased to 80 Hz and procedures are carried out until the symptoms of the disease disappear.

The power up to 90 mW is increased only at the third stage, if required. And the pulse frequency in this case becomes much higher (600 Hz and more).

The number of procedures and the interval between courses are determined by the attending physician. Improvement may occur after 5-6 procedures, but this does not mean that the treatment is over. Stopping the treatment immediately after the pain has subsided means increasing the likelihood of a relapse.

If the bone growth is large or continues to grow after treatment, the laser is used not as a means of physiotherapy, but as a variant of minimally invasive surgery. It can be used to crush the calcium formation so that it does not interfere with walking, but the question of the inflammatory process after such an operation remains open.

The advantage of laser removal of osteophytes is the absence of a large surgical incision on the leg and the need for anesthesia. The operation is performed using local or intraosseous anesthesia. A puncture is made in the heel tissue with a powerful needle, through which a laser beam is fed directly to the pathological neoplasm. Under the influence of high-frequency electromagnetic radiation, the growth disintegrates into small particles, which are removed naturally with the blood flow.

The thermal effect of the laser causes coagulation of the vessels, which prevents bleeding, has an antimicrobial effect, and helps reduce the sensitivity of nerve endings. After the procedure, the patient no longer feels that pain, the inflammation gradually subsides, and normal gait is restored.

The procedure for removing a heel spur takes a little less than an hour. Most of the time is spent on puncturing soft tissues, perforating the bone, introducing an intraosseous anesthetic and waiting for it to take effect.

Contraindications to the procedure

Laser treatment of heel spurs and many other pathologies is becoming an increasingly common procedure, because when used correctly, laser radiation is a relatively safe and very effective medical instrument that can penetrate to great depths without damaging tissue.

However, there are pathologies and conditions in which even such gentle action can be dangerous, provoking undesirable reactions and processes in the body. We are talking about relative and absolute contraindications to laser treatment.

There is an opinion that laser therapy has no absolute contraindications. However, in some situations, doctors prefer to play it safe and not perform the procedure if there is a risk of complications. In what cases can a doctor refuse to perform a laser treatment or removal of a heel spur?

Temporary restrictions include elevated body temperature, acute infectious diseases, and high blood pressure. Due to these symptoms, the procedure may be postponed for a certain time.

In what situations does a doctor have the right to refuse a patient:

• in the presence of an active form of tuberculosis,
• if syphilis is detected,
• in such a rare pathology as brucellosis, which in isolated cases is transmitted to humans from animals,
• with a diagnosis of diabetes mellitus,
• in various tumor processes, including benign ones,
• if there is a disorder in the functioning of the thyroid gland, as a result of which there is an excess of thyroid hormones in the body (thyrotoxicosis),
• for blood diseases,
• in decompensated heart failure,
• in case of development of pulmonary insufficiency,
• in case of a negative reaction to laser radiation,
• in case of neuropsychiatric disorders.

As for pregnant women, any manipulations during this period should be discussed with your gynecologist. Laser irradiation of the heel is unlikely to have a negative impact on the development of the child inside the womb, but any procedure or operation is stress for the body, which can have various unpredictable consequences.

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Consequences after the procedure

Since we have come close to the issue of the consequences of laser treatment of heel spurs, it is worth saying that they will mostly be positive if the operation is performed taking into account contraindications. The fact is that laser therapy has a number of advantages over other methods of treating heel spurs, which allow you to avoid many unpleasant moments after the procedure.

Laser treatment is a procedure that has an anti-inflammatory and analgesic effect without the use of medications, which, as we know, usually have a considerable list of side effects. This means that laser manipulations do not have any negative impact on internal organs.

Unlike external medications, laser therapy practically does not cause allergic reactions, unless an intolerance reaction is provoked by some characteristics of the patient’s body.

Unlike X-rays, laser radiation does not have a negative effect on healthy tissues. On the contrary, narrowly focused induced radiation only increases blood flow and helps maintain homeostasis, which in turn helps implement regenerative processes in the body's tissues.

During the treatment procedure, the patient does not feel pain, and local anesthesia is sufficient for removing the spur. This is a good way to avoid side effects of anesthesia. In addition, a person can easily endure a fairly long course of procedures, which is important for achieving a lasting effect.

By the way, relapses after laser treatment of heel spurs occur very rarely, and only if the patient does nothing to eliminate the causes that cause ligament rupture and inflammation.

What is also very important is that both treatment and removal of heel spurs do not require preliminary hospitalization of the patient. The person continues to live his usual life and visits the hospital only at the appointed time for the procedure. After the procedure, he calmly returns to his usual activities.

What do we get as a result of laser treatment? Blood circulation in the lower part of the leg improves, the production of cellular and plasma inflammation mediators decreases, which means that the symptoms of the inflammatory process (local increase in body temperature, hyperemia and tissue edema) gradually subside, and metabolism is normalized. Moreover, the laser is able to activate the body's internal forces to fight the disease. All this helps to reduce inflammation and pain syndrome, which is caused not so much by the shape or size of the osteophyte, but by inflammation of the soft tissues and nerve endings due to their compression and damage by the growth.

As for the effect on osteophytes, at low laser frequencies they are not destroyed. However, activation of bone tissue cells responsible for bone destruction (osteoclasts) is noted. These cells lead to the fact that over time the size of the osteophyte decreases. Small growths can disappear altogether. And if there is no irritating factor, then after a while the pain will also go away. And all thanks to the laser.

What are the consequences of laser treatment? After several sessions, the swelling of the tissues in the heel area goes away, the inflammation noticeably decreases and then completely disappears, the intensity of the pain syndrome gradually decreases procedure after procedure, under the influence of laser radiation, the tissues recover faster, i.e. regeneration processes begin to actively occur in them. At the end of the course of treatment, the person returns to his previous healthy life.

But even if it is not possible to completely get rid of the unpleasant symptoms of heel spurs, the patient still gets the opportunity to walk normally and perform his work duties, his ability to work is restored, which is especially important if the disease has affected the main breadwinner in the family.

Yes, laser treatment may not be a cheap pleasure, but it allows you to restore your ability to work and earn money, so the costs are compensated. And what is the restoration of the patient's psycho-emotional state worth when he returns to a life without pain.

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Complications after the procedure

Complications during laser treatment of heel spurs can occur in three cases:

• if contraindications to the procedure were not taken into account,
• if the patient does not follow the wound care requirements after the spur is removed or the infection was introduced during the operation,
• if factors that provoke a repeated inflammatory process are not excluded.

In the first case, complications will affect not so much the organ affected by the disease as other organs and systems of the human body. For example, laser exposure can provoke tumor growth, the appearance of metastases or the spread of infection throughout the body.

The second case involves suppuration of the tissue puncture site due to infection getting inside the wound. This is possible if the skin at the puncture site or the syringe needle were not sufficiently sterile (in other words, they were not properly treated with antiseptics) or the infection got into the wound after the operation due to failure to comply with postoperative care requirements (a loosely fitting bandage, insufficient wound treatment, failure to maintain hand and foot hygiene).

By the way, the cause of purulent inflammation can be ignoring such a disease as diabetes. In diabetics, any wounds on the body heal for a very long time, so they are prone to infection. But if laser treatment of spurs does not require perforation of tissues, then laser removal involves their deep puncture.

The third situation is the most common complication, which is called a relapse of the disease. No matter how powerful the laser effect may seem, it can only relieve inflammation, but not prevent the appearance of new ruptures and associated inflammatory processes. A lasting effect from laser treatment is possible if you exclude the impact of negative factors in the future.

And still, any complications after laser treatment will seem trivial compared to the possible negative consequences of surgery: impaired sensitivity of the limb or foot due to nerve damage, development of neuromas (nerve fibers that have grown after damage), foot deformation, complications after anesthesia. Moreover, complications due to non-compliance with contraindications, the risk of wound infection, a long period of healing of the incision on the leg, the likelihood of relapses during surgical intervention still remain.

Let's say that nerve damage and related complications are possible with laser therapy if the surgeon does not have enough experience in performing such operations. After all, it is necessary to be able to not only manipulate the laser, but also make a careful puncture in the right place so as not to damage multiple nerves in the foot area, as well as skillfully regulate the pulse frequency and power of the device depending on the situation. And yet, the probability of such complications with laser therapy is several times lower than with surgery.

It turns out that laser treatment of spurs helps to avoid many unpleasant complications typical of a regular operation, postoperative pain at the site of manipulation, and a long period of rehabilitation.

Care after the procedure

Another advantage of laser treatment of heel spurs is the short recovery period. One procedure is enough for the discomfort in the heel area to go away forever. At the same time, after the operation, the person can go home. His stay in the hospital is not necessary, because he does not need to recover from anesthesia, have the incision stitched, processed and removed later.

The patient spends the rehabilitation period at home. After the operation, the small puncture wound is treated with an antiseptic again and an aseptic bandage is applied. Usually, the wound heals quickly on its own. It is only important to ensure that dust and dirt do not get into it, to observe hygiene requirements (wash the foot with soap and water), if necessary, treat the wound with antiseptic solutions and seal it with a bandage. If healing is slow, you can resort to the help of wound healing agents containing antimicrobial components (for example, Levomekol ointment).

But wound care is not everything. After any operation, it is better to reduce the load on the legs, especially on the heels, during the recovery period. Special orthopedic insoles or shoes will help with this. They are recommended to be worn in the first 2 months after the operation. But it turns out that a person gets used to the comfort, feels the difference and wears the insoles regularly, which allows avoiding all sorts of foot deformations, ligament ruptures, leg diseases associated with their overstrain.

For the first couple of months, doctors advise against long walks, taking a break from sports, and not carrying or lifting heavy objects. However, swimming, massage, and therapeutic exercise will only be beneficial and will help shorten the recovery period.

If you recall the reasons why heel spurs occur, it becomes clear that not everyone will be able to limit themselves to just orthopedic insoles. To prevent the situation from repeating itself, some will have to say goodbye to excess weight or high heels, others will have to treat existing pathologies related to risk factors for the development of plantar fasciitis, and then the appearance of heel spurs. And also take medications to normalize peripheral circulation and metabolic processes, regularly do gymnastics for the feet, which will maintain the elasticity of the ligaments, lead an active lifestyle, but at the same time regulate the load on the legs.

Reviews of laser treatment for heel spurs

Those who have experienced all the horrors of a heel spur will never want to go through it again. Piercing pain when standing up and walking, difficulty moving due to the inability to step on the heel, aching pain at night, limited ability to work, depression - these are the moments that make a person seek help from doctors. But how we want this help to be not only effective and safe, but, if possible, painless, because a person is already exhausted by pain.

It is because of the effectiveness, safety and absence of pain during laser treatment of heel spurs that people turn to this expensive method of fighting the disease. Although those who have tested other methods on themselves claim that the cost of laser therapy is lower than some other therapeutic methods.

Everyone who has undergone at least several laser therapy procedures notes a significant reduction in pain. Already from the first procedures, patients find it easier to walk. And after completing the full course of treatment, people get a lasting effect.

Some people have been pain-free for over a year, while others have been living without discomfort for over six years with laser treatment. But there are also those who still can't bring themselves to say goodbye to the source of pain due to fear, financial difficulties, or simply unwillingness to undergo procedures regularly. At the same time, others travel dozens of kilometers from villages to large cities every day to attend laser therapy sessions, and they do not regret it, because the treatment helped them return to normal life and forget about pain for many years.

According to reviews, patients who had heel spurs diagnosed at an early stage, said goodbye to them forever with the help of a laser, without resorting to surgery or other methods of treatment. Those whose process turned out to be neglected, in combination with laser therapy, use traditional methods of treatment or use pharmaceutical products.

An interesting and highly effective treatment option is considered to be a combination of drug and laser therapy, since the latter enhances the effect of drugs.

In principle, orthopedists also insist on complex treatment of heel spurs. They in no way belittle the properties of the laser, and on the contrary, consider such therapy a very promising method. And yet, in order to obtain a quick and lasting result, according to experts, it is better to combine several methods and means.

As for the removal of heel spurs using a laser, patients note the absence of pain and a short rehabilitation period. Many were able to return to work almost immediately, although there was initially a risk of losing it due to limited movement and loads on the legs.

Reviews of relapses of the disease after laser treatment of heel spurs are extremely rare. And this once again confirms the lasting result of the treatment. Plus, patients who have gone through the pain begin to treat their life and health differently. They are no longer lazy in doing gymnastics and massage, they prefer orthopedic shoes and insoles, which reinforces the effect of laser treatment.