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M77.3 Heel Spur – Causes, Symptoms & Treatment
M77.3 is the ICD-10 code for heel spur, a bony growth on the heel bone. It causes pain and is treated conservatively or surgically.
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M77.3 is the ICD-10 code for heel spur, a bony growth on the heel bone. It causes pain and is treated conservatively or surgically.
What is M77.3 – Heel Spur?
The ICD-10 code M77.3 refers to a heel spur (calcaneal spur), a bony outgrowth on the heel bone (calcaneus). This bony projection forms as a result of chronic overload and can cause significant pain. A distinction is made between the plantar heel spur (on the underside of the heel) and the dorsal heel spur (at the back of the heel, near the Achilles tendon).
Causes
A heel spur develops due to repeated tension at the insertion point of the plantar fascia or the Achilles tendon on the heel bone. Common causes and risk factors include:
- Chronic overuse of the foot (e.g., prolonged standing or intense physical activity)
- Excess body weight and elevated body mass index (BMI)
- Poorly fitting or inadequately cushioned footwear
- Foot deformities such as flat feet or high arches
- Shortened calf muscles or plantar fascia
- Increasing age
Symptoms
Not every heel spur causes discomfort. When pain does occur, typical symptoms include:
- Start-up pain: A sharp, stabbing pain with the first steps in the morning or after prolonged sitting
- Pain when placing weight on the heel
- Tenderness to pressure on the heel
- Pain that worsens with prolonged activity
Diagnosis
The diagnosis of a heel spur is made through:
- Medical history and physical examination: Characteristic pain patterns and pressure tenderness at the heel
- X-ray: Visualization of the bony spur on the heel bone
- Ultrasound: Assessment of the plantar fascia and signs of inflammation
- MRI (Magnetic Resonance Imaging): Used in unclear cases for detailed soft tissue evaluation
Treatment
Conservative Treatment
The majority of heel spur cases can be managed with conservative approaches:
- Physiotherapy and stretching exercises: Targeted stretching of the calf muscles and plantar fascia
- Orthotics and supportive footwear: Cushioned heel insoles to relieve pressure on the heel
- Anti-inflammatory medications: Non-steroidal anti-inflammatory drugs (NSAIDs) for pain relief
- Cold therapy: Local ice application to reduce swelling and pain
- Corticosteroid injections: Local injections for severe pain
- Extracorporeal shock wave therapy (ESWT): A non-invasive treatment using sound waves to stimulate healing
Surgical Treatment
Surgery is only considered when all conservative measures have failed to provide adequate relief over several months. The procedure involves removal of the bony spur and/or partial release of the plantar fascia.
Prognosis
With consistent conservative treatment, most patients experience significant improvement within 6 to 12 months. Early intervention and elimination of risk factors considerably improve the long-term outlook.
References
- World Health Organization (WHO): ICD-10 Classification of Diseases, Code M77.3 – Calcaneal Spur.
- Roxas M. – Plantar Fasciitis: Diagnosis and Therapeutic Considerations. Alternative Medicine Review, 2005; 10(2): 83–93.
- Buchbinder R. – Clinical Practice: Plantar Fasciitis. New England Journal of Medicine, 2004; 350(21): 2159–2166.
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