Upper heel spurs can be classified depending on the cause and manifestation:

1. Mechanical heel spur: Caused by chronic friction or pressure, such as from tight shoes.
2. Structural heel spur: Changes in bone shape due to congenital or growth disorders.
3. Inflammatory heel spur: Accompanying inflammatory processes such as Achilles tendinitis.

The main causes of a superior heel spur are:

- Mechanical overload:

- Persistent pressure or friction from unsuitable footwear.

- Misalignments:

- Foot misalignments such as a high arch or flat foot increase pressure on the heel region.

- Excessive athletic activity:

- Intensive strains, especially from running or jumping, can promote development.

- Genetic factors:

- A familial predisposition can influence bone structure and thus the formation of a superior heel spur.

The symptoms of an upper heel spur are characteristic and include:

• Local pain: Pain at the upper back of the heel, especially with pressure or movement.
• Swelling: Visible and palpable swelling in the area of the Achilles tendon.
• Redness and irritation: Skin irritations due to friction, often caused by shoes.
• Movement restrictions: Pain when walking, especially during sports activities or barefoot on hard floors.
• Pressure sensitivity: Increased pain when touching or pressing on the affected area.

The diagnosis is based on a combination of medical history, clinical examination, and imaging techniques:

- Medical History:

- The doctor inquires about typical symptoms, possible triggers, and shoe habits.

- Clinical Examination:

- Visual and tactile findings to identify the bony protrusion and painful areas.

- Imaging Techniques:

- X-ray: Visualization of bony changes and size of the heel spur.

- MRI: Detailed assessment of soft tissue damage and inflammation.

- Ultrasound: Examination of the Achilles tendon and adjacent structures.

Conservative Therapy

Most cases can be treated without surgery:

• Shoe Adjustment:
  • Avoiding tight, pressing shoes and using shoes with soft padding in the heel area.
• Orthopedic Insoles:
  • Special insoles for pressure relief and improvement of foot positioning.
• Physiotherapy:
  • Exercises to strengthen the calf muscles and relieve the Achilles tendon.
• Cold or Heat Applications:
  • Relief of pain and inflammation through targeted applications.
• Medication Therapy:
  • Taking NSAIDs to reduce pain and inflammation.

Surgical Therapy

If conservative measures are not sufficient, surgery may be necessary:

• Removal of Heel Spur:
  • Removal of the bony protrusion for pressure relief.
• Achilles Tendon Correction:
  • If the tendon is also involved, it can be treated surgically.

To prevent a superior heel spur, the following measures are helpful:

1. Suitable footwear: Wearing shoes with sufficient space and soft padding in the heel area.
2. Avoiding overstrain: Limiting intense sports activities and regular recovery phases.
3. Strengthening the muscles: Specific exercises to strengthen the calf and foot muscles.
4. Regular exercise: Promoting blood circulation and relieving the heel area through joint-friendly sports such as swimming or cycling.
5. Early detection: Timely response to the first signs of pain or swelling.