Treating the calcaneal spur with a laser

The calcaneal spur, which is also a plantar fasciitis, is considered one of the most popular "sores" of people over forty. This disease is unpleasant in that it causes acute pain in any load on the heel. The cause of these pains is a bone protrusion behind the foot at the junction of the calcaneus and tendons. Treating the calcaneal spur with a laser is one of the popular therapies for this disease, which involves either the removal of inflammation and pain with a small amount of bone formation, or the removal of calcite with a laser beam, adjusted power.

A little about the disease itself

Legs are a part of the human body, which daily undergoes a tremendous load, because the weight on the lower limbs plus the weights that we carry. It's no wonder that at some point we may experience pain in the legs. But this pain is different, and by its nature we can understand the cause of such an unpleasant symptom.

If it is a burning piercing pain behind the foot when walking or any load on the heel, it is most likely associated with the calcaneal spur. Where does this pain come from in the heel?

Plantar fasciitis, as the name suggests, is an inflammatory disease of the foot, in which an inflammation of the aponeurosis supporting the longitudinal arch occurs. At the site of inflammation in the area of the calcaneus, a bone growth can be formed, ranging in size from a few millimeters to 1.2 cm. It usually has a wedge-shaped shape and, with its sharp end, causes irritation of the adjacent tissues, which causes sharp pain in the heel.

But the calcaneal spur is already a consequence of the inflammatory process. But even inflammation does not occur without a cause. As for the cause of inflammation of the plantar fascia, it often consists of a strong overstrain of the tissues, which causes microtraumas (microscopic ligament tears). If the load is irregular the microcracks quickly and painlessly heal. But with constant loads of tissue fascia and nearby soft tissues can become inflamed without the possibility of recovery, because they are not allowed to recover from regular excessive stress on the foot.

On the site of long-term internal inflammation, the metabolism in tissues is disrupted, resulting in the deposition of calcium salts in this area. A small spur can be found on the X-ray, even when the person is not yet experiencing pain under pressure on the heel. As the spur grows, pain appears, which is more intense with time, and the inflammatory process spreads further to the foot.

Where does excessive load on the heel? Most often, flat foot is caused by an incorrect distribution of the load on different areas of the foot. In this pathology, tendons on the spot are constantly in a strong strain and any effect on them (for example, a person stepped on a hillock or a pebble) can lead to the appearance of microscopic ruptures. Even if this rupture is cicatrizing, in the future, under pressure, the scar can again disperse and become inflamed.

Why is the calcaneal spur more characteristic of people after 40 years of age? The reason lies in the age changes, because over time, the regenerative processes take place in our body all the worse. And if we add to this the circulatory disturbances typical of most elderly people, and the large load of foot loads leading to the accumulation of healed microdamages on it, then in older people the problem begins to take on a global scale.

Is it possible to have a heel spur in young? Strange as it may seem, yes. This disease is characteristic of athletes who have a heavy load on the bones and ligaments of the foot. Those who are professionally engaged in jogging or jumping can be safely attributed to the risk of fasciitis and heel spur.

Such a disease is more characteristic of women because of their addiction to high heels. And the higher the heel in his youth, the more likely the appearance of a calcaneal spur to the age of thirty to forty. After wearing heels leads to an incorrect redistribution of the load, as a result of which the individual parts of the foot and ligament are more stressed than others. There are minor injuries, inflammation and a bone growth. Referring to the doctor for pain in the heel leads to the appointment of treatment of the heel spur medicamentously, ultrasound, laser and other available methods.

Calling the reasons for the formation of the heel spur, we mentioned flat feet. But this pathology is not the only one that can lead to the appearance of build-up on the foot. A large load on the legs with an increased likelihood of injuring the limbs in the tendon and fascia area is observed in people suffering from obesity. The appearance of bone growth can lead to metabolic disorders (diabetes mellitus or gout), heel bone injury, peripheral circulation disorders due to poor permeability of the vessels, inflammation of the joints, muscles and mucous bags in the area of the joints of the foot. The calcaneal spur may well be an unpleasant consequence of a previous serious illness.

The main symptom of the heel spur is acute pain in the heel when pressing on it. A person has a feeling that he drove a big sharp piece of wood in the leg. As the pathology develops, the pain from short-term pain that occurs when the foot is loaded, becomes permanent, for which there is no longer any mechanical effect on the spur area. Constant pains are caused already by a strong inflammation of tissues inside the heel.

It is clear that a person who can not normally stand on his foot develops hypodynamia. Efforts to step as little as possible on a sore spot lead to a change in gait, and sometimes to deformation of the foot. It would seem that all the symptoms are obvious, and you can immediately diagnose, but doctors still prefer to be reinsured. Confirm the initial diagnosis is an honor X-ray foot.

[1], [2]

How is the heel spur treated?

Since any spur (both large and small) arises against the background of inflammation and is accompanied by a severe pain syndrome, 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 and does not seriously injure nearby tissues, patients are treated with medication, physiotherapy, wearing corrective orthopedic shoes, massage, foot gymnastics, warm baths and compresses.

Medicamental treatment gives good results with plantar fasciitis if the spur is small in size. To remove inflammation and destroy the emerging bone formation, use the drug bile in the form of compresses (at least 20 procedures), the use of steroid and non-steroidal anti-inflammatory drugs: dimexide, hydrocortisone, diprospan. Local treatment includes applying to the area of inflammation and the formation of spurs ointments that contribute to reducing the inflammatory process and resorption of tumors.

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

If the spur continues to grow, we must look for other methods that can bring back the joy of movement to the patient. To relieve pain, drug blockades are carried out, and X-ray methods are used. To reduce the pathological neoplasm, shock wave therapy, ultrasound, laser, magnetic field, etc. Are used. Or surgical treatment.

The most sparing and effective instrumental methods for treating the heel spur are shock wave therapy, laser therapy and ultrasound, which can be attributed to physiotherapy treatment. 

Shockwave therapy is the directed action of waves of a certain frequency, designed to destroy the bone growth without the aid of surgical intervention. The technique is applied on spurs of small and medium size. For growths less than 2 mm it is ineffective.

Ultrasound does not contribute to the removal of bone growth, 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, intoxications, acute infectious diseases, thrombophlebitis, mental and some neurological diseases, arrhythmias, etc.).

Treating the calcaneal spur with a laser is one of the innovative methods that has a minimum of contraindications and shows good results. In addition, it makes it possible to choose one of the most preferable treatment options, because, depending on the frequency of laser radiation, it can either treat inflammation, or remove a painful sensory growth.

Indications for the procedure

The localization of inflammation (at the periphery, away from the central blood vessels), the high sensitivity of the zone (a large number of nerve endings on the sole), the inability to completely isolate the affected area from stress and damage lead to the fact that medication does not always give tangible results. And even if the inflammation is removed, but there is no guarantee that the disease will not return.

Drug therapy with heel spur is mainly a local treatment with anti-inflammatory and analgesic ointments, gels, creams. In order for this therapy to be effective, it is necessary to provide easy access of external means to the tissues, which is not so simple with rough skin on the heel. So, in addition to regular rubbing of the ointment (at least 3 times a day) and massages, you also need several times a day to do pairing the skin on the foot and peeling.

In itself, the external use of medicaments and curative patches rarely gives a lasting result if it is not backed up by physiotherapy procedures. The same electrophoresis with anesthetics allows you to inject pain medications more deeply into the tissues, which greatly facilitates the pain syndrome.

One of the most effective methods of drug treatment are injections of corticosteroids into the heel joint, which allows you to deliver the medicine directly to the inflammation zone. But in order for the patient to be relieved and recovered, at least 2-3 such injections are necessary, during which the person has to experience severe pain similar to pain when removing a tooth firmly in the hollow of the tooth without anesthesia.

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

In principle, a doctor can offer such a treatment option initially, but everything will depend on the considerable cost of the quantum therapy procedure, so I prescribe laser treatment mainly when other methods did not give a good result.

[3], [4], [5], [6]

Preparation

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

Laser therapy has not so many contraindications, therefore laboratory studies are mainly limited to clinical blood and urine tests. In addition, blood tests for sugar and thyroid hormones can be prescribed for suspected endocrine diseases.

A general blood test will show whether there is an acute infectious process in the body, whether the viscosity of the blood is not broken, whether there are other blood diseases.

If the total blood test shows an increase in ESR and the number of white blood cells, a decrease in the number of platelets, the presence of lympho- and myeloblasts against the background of a decrease in total hemoglobin, which can speak of malignant processes in the body, specific assays for the detection of cancer cells will additionally be prescribed.

In any case, even before the appointment of the operation, the doctor will have to carefully study the patient's anamnesis in order to exclude pathologies in which exposure to the laser can harm. Special studies (even if only a cardiogram) will be prescribed if there are suspicions of heart disease or respiratory system.

The x-ray of the foot will be assigned to the patient without fail. And not only to confirm the diagnosis, but in order to determine the size, shape and location of bone growth. This is especially important if the treatment does not work and the spur has to be removed.

About what, perhaps, the patient still have to take care, it's about the cleanliness of the legs and the removal of coarse skin and calluses on the heel (steaming and pumice or brush or salon procedure). For a laser, this, of course, is not an obstacle, and yet the procedure is carried out with a certain frequency of waves, which hardly anyone will correct for the thickness of the skin on the foot.

[7], [8]

Technique of the laser treatment of heel spurs

Treating the calcaneal spur with a laser is a non-invasive procedure, so it does not require either total disinfection or special training. The requirement of cleanliness of feet is purely aesthetic and emerges from the rules of hygiene. An additional requirement is absolute dryness of the skin on the foot.

The procedure itself does not require a hospital stay. It is conducted in an outpatient setting, in an office equipped with special equipment. In principle, the equipment (laser device) is portable, so there are no special requirements for placement.

The device for laser therapy is a small device consisting of an LED with a power supply and handles. The patient lies on a couch with bare feet during the procedure. The doctor at this time moves the device emitter along the surface of the heel, lingering at certain points, which allows to effect in 4 projections, covering the entire area of inflammation:

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

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

Alas, one procedure to reduce inflammation and relieve pain arising from the calcaneal spur will not be enough. Moreover, a full course of laser therapy includes 10-15 such procedures, conducted daily.

But even this course can be limited only at the initial stage of the disease. Typically, doctors recommend to undergo 2 and even 3 courses of laser exposure with a sequential increase in the power of the device and the pulse frequency. The interval between courses is not less than 2 weeks.

Laser power during laser therapy is not very different indicators and fluctuates within 80-90 mW. But the frequency indicators vary considerably. During the first course of treatment, the frequency of laser radiation is minimal - 50 Hz. In the second course, the frequency is increased to 80 Hz and procedures are performed until the symptoms of the disease disappear.

Power up to 90 mW is increased only in the third stage, if required. And the frequency of pulses in this case becomes much larger (600 Hz and more).

The number of procedures and the amount of interval between courses is determined by the attending physician. Improvement may occur after 5-6 procedures, but this does not mean that the treatment is over. To interrupt treatment immediately after pain reduction means to increase the probability of relapse.

If the bone growth is large or continues to grow after the treatment, the laser is no longer used as a means of physiotherapy, but as an option for minimally invasive surgery. With its help, it is possible to break up 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. In the tissues of the heel, a powerful puncture is made through which the laser beam is delivered directly to the pathological neoplasm. Under the influence of high-frequency electromagnetic radiation, the built-up part breaks up into small particles, which are removed naturally by the blood flow.

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

The procedure for removing the calcaneal spur takes a little less than an hour. And most of the time goes to piercing soft tissue, bone perforation, intraosseous anesthetic injection and waiting until it works.

Contraindications to the procedure

Laser treatment of the calcaneal spur and many other pathologies is becoming more and more common procedure, because when used correctly laser radiation is a relatively safe and very effective medical tool capable of penetrating to great depth without damaging the tissues.

However, there are pathologies and conditions in which even such careful treatment can be dangerous, provoking unwanted reactions and processes in the body. This is a relative and absolute contraindications to laser treatment.

There is an opinion that laser therapy has no absolute contraindications. Nevertheless, in some situations, doctors prefer to be reinsured and do not perform the procedure if there is a risk of complications. In what cases can the doctor refuse to perform the procedure for treating or removing the heel spur with a laser?

Temporary limitations include elevated body temperature, acute infectious diseases, high blood pressure. In connection with these symptoms, the procedure can be postponed for a certain time.

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

• if there is an active form of tuberculosis,
• in the case of syphilis,
• with such a rare pathology as brucellosis, which in a few cases is transmitted to humans from animals,
• when diagnosed as "diabetes mellitus,
• at various tumoral processes, including benign,
• if there is a disruption of the thyroid gland, as a result of which an excess of thyroid hormones (thyrotoxicosis) is observed in the body,
• with blood diseases,
• with decompensated heart failure,
• in case of development of pulmonary insufficiency,
• with a negative reaction to laser radiation,
• in the case of neuropsychic disorders.

As for pregnant women, any manipulations in this period should be discussed with your gynecologist. Laser irradiation of the heel can hardly adversely affect the development of the child inside the uterus, but any procedure or operation is a stress for the body, which can have various unpredictable consequences.

[9], [10]

Consequences after the procedure

Since we came very close to the issue of the effects of treating the heel spur with a laser, it should be said that they are mostly positive only 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 the heel spur, which allow to avoid many unpleasant moments after the procedure.

Laser treatment is a procedure that exerts 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 no one has a negative effect on the internal organs of manipulation with the laser.

In contrast to external medicamentous agents, laser therapy practically does not have allergic reactions, except that the intolerance reaction will be provoked by some peculiarities of the patient's body.

In contrast to X-ray radiation, the laser beam does not adversely affect healthy tissues. Conversely, narrow-directed induced radiation only increases blood flow and helps maintain homeostasis, and this in turn promotes the implementation of regenerative processes in the tissues of the body.

During the treatment, the patient does not experience pain, and when removing the spur, local anesthesia is sufficient. This is a good opportunity to avoid side effects of anesthesia. In addition, a person can safely withstand a fairly long course of procedures, which is important to achieve a lasting effect.

By the way, relapses after treatment of calcaneal spurs with a laser occur very rarely, and only if the patient does nothing to remove the causes that cause ligament ligation and inflammation.

What is still very important, both treatment and removal of the calcaneal spur do not require a patient's prior hospitalization. The person continues to live a habitual life, and the hospital visits only at the appointed time for the procedure. After the procedure, he calmly returns to his usual business.

What do we have as a result of laser treatment? The blood circulation in the lower part of the leg improves, the production of cellular and plasma mediators of inflammation decreases, which means the symptoms of the inflammatory process (local increase in body temperature, hyperemia and tissue swelling) gradually dry up, the metabolism is normalized. Moreover, the laser is able to activate the internal forces of the body to fight the disease. All this contributes to the reduction of inflammation and pain syndrome, which is caused not so much by the shape or size of the osteophyte, as by the inflammation of the soft tissues and nerve endings due to their squeezing and damage by the build-up.

As for the effect on osteophytes, at low frequencies of the laser their destruction does not occur. But there is an activation of bone cells responsible for the destruction of bones (osteoclasts). These cells and 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 in time the pain will also go away. And all thanks to the laser.

What are the consequences of laser treatment? For several sessions, swelling of tissues in the heel area, significantly decreases, and then completely undergoes inflammation, gradually the procedure after the procedure reduces the intensity of the pain syndrome, under the influence of laser radiation, tissues are quickly restored, i.e. Regenerative processes begin to take place actively in them. At the end of the course of treatment a person returns to his previous healthy life.

But even if he did not manage to get rid of the unpleasant symptoms of the calcaneal spur, the patient still gets the opportunity to walk normally and fulfill his labor duties, his working capacity is restored, which is especially important if the disease struck 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 psychoemotional state when he returns to life without pain.

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Complications after the procedure

Complications in the treatment of calcaneal spurs with a laser can occur in three cases:

• if contraindications to the procedure were not taken into account,
• if the patient does not comply with the requirements of care for the wound after the removal of the spur, or if the infection was entered during surgery,
• if factors that provoke a second inflammatory process are not excluded.

In the first case, the complications will concern not so much the diseased organ as other organs and systems of man. For example, exposure to the laser can trigger tumor growth, the appearance of metastasis, or the spread of infection throughout the body.

The second case implies the suppuration of the site of the puncture of the tissues due to the ingress of infection into the wound. This is possible if the skin at the puncture site or needle of the syringe was not sterile enough (in other words, they were poorly treated with antiseptics) or the infection was wounded after surgery because of non-compliance with post-operative care requirements (loosely fitting bandage, insufficient wound treatment, non-compliance with hand hygiene and feet).

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

The third situation is just the most popular complication, which is called a relapse of the disease. No matter how powerful the laser effect may seem, it can only relieve the inflammation, but not prevent the emergence of new discontinuities and associated inflammatory processes. A persistent effect of laser treatment is possible if negative factors are subsequently excluded.

And still, any complications after laser treatment will seem a trifle compared to the possible negative consequences of a surgical operation: violation of the sensitivity of the limb or foot due to nerve damage, neuroma development (enlarged nerve fibers after injury), deformities of the foot, complications after anesthesia. Moreover, complications due to non-compliance with contraindications, the risk of infection of the wound, a long period of healing of the incision on the leg, the likelihood of relapse during surgery remains.

Let's just say, nerve damage and related complications are possible with laser therapy, if the surgeon does not have enough experience in such operations. Still, you need to be able not just to manipulate the laser, but also to make a neat puncture in the right place, so as not to damage the multiple nerves in the foot area, and also skillfully adjust the pulse frequency and the power of the device, depending on the situation. Yet the likelihood of such complications in laser therapy is several times lower than in a surgical procedure.

It turns out that laser treatment of the spur helps to avoid a lot of unpleasant complications, typical for a routine operation, postoperative pain in the place of manipulation, a long period of rehabilitation.

[12], [13]

Care after the procedure

Another advantage of treating the calcaneal spur with a laser can be considered a short recovery period. It is enough for one procedure, so that the discomfort in the heel area is gone for good. In this case, after the operation, a person can go home. His presence in the hospital is not necessary, because he does not have to go away from anesthesia, to sew the incision, to process it and to remove the seams afterwards.

The patient spends the rehabilitation period at home. After the operation, a small wound from the puncture is treated once again with an antiseptic and applied an aseptic bandage. Usually the wound is quickly tightened by itself. It is important only to ensure that it does not get dust and dirt, comply with hygiene (wash your foot with soap and water), if necessary, treat the wound with antiseptic solutions and glue it with adhesive tape. If healing is slow, it is possible to resort to the use of wound healing agents containing antimicrobial components (for example, "Levomekol" ointment).

But caring for the wound is not everything. For any operation in the recovery period, it is better to reduce the load on the legs, and especially on the heels. Help in this special orthopedic insoles or shoes. They are advised to wear in the first 2 months after the operation. But it turns out that people get used to comfort, feel the difference and wear insoles regularly, which avoids all sorts of deformities of the foot, rupture of ligaments, leg diseases associated with their overstrain.

The first couple of months, doctors advise not to make long walks, relax from sports, do not wear or lift weights. But swimming, massage and physiotherapy will only benefit and will shorten the recovery period.

If you recall the reasons for the heel spur, it becomes clear that not everyone will be able to limit themselves to orthopedic insoles. To the situation does not happen again, someone has to say goodbye to excess weight or high heels, others - to treat the existing pathologies related to the risk factors for plantar fasciitis, and, after him, the appearance of a calcaneal spur. And also take drugs to normalize the peripheral circulation and metabolic processes, regularly perform 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 about laser treatment of calcaneal spurs

Those who have experienced all the horrors of the calcaneal spur will not want to go through it again. A piercing pain when getting up and walking, difficulty in moving because of the inability to step on the heel, aching pain at night, limitation of working capacity, depression are moments that force a person to seek help from doctors. But how you want, that this help was not only effective and safe, but as far as possible and painless, because a person is already exhausted with pain.

It is because of the effectiveness, safety and absence of pain during the procedures for treating the calcaneal spur by a laser that people turn to this expensive method of fighting the disease. Although those who tested themselves and other methods, argue that the cost of laser therapy is lower than some other therapeutic methods.

Anyone who has undergone at least several laser therapy procedures has noted a significant reduction in the pain syndrome. Even with the first procedures, it becomes easier for patients to walk. And after completing the full course of treatment, people get a lasting effect.

Someone has not experienced pain for more than a year, and someone has been helped by laser treatment to live without discomfort for more than six years. But there are also those who still do not dare to say goodbye to the source of pain because of fear, financial difficulties or simple reluctance to regularly go to the procedures. At the same time, others made their way every day tens of kilometers from villages to major cities to attend laser therapy sessions, and did not regret it, because the treatment helped them to return to normal life and forget about the pain for years to come.

Judging by the reviews, patients with heel spur was diagnosed at an early stage, with the help of a laser, said goodbye to her forever, without resorting to surgery and other methods of treatment. Those who have the process turned out to be running, in combination with laser therapy, use alternative methods of treatment or apply pharmaceutical means.

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

In principle, on the complex treatment of the calcaneal spur, orthopedists also insist. They in no way detract from the properties of the laser, and vice versa, consider such therapy a very promising method. And yet, to get a quick and lasting result, according to experts, it is better to combine several methods and means.

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

Reviews of the recurrence of the disease after laser treatment of the calcaneal spur are extremely rare. And this once again confirms the persistent result of the treatment. In addition, patients who have gone through pain begin to treat their life and health differently. They are not too lazy to do gymnastics and massage, they prefer orthopedic shoes and insoles, thus fixing the effect of laser treatment.