Patient: Description (onset time, main symptoms, hospital, etc.): Hello doctor, I am a male, 31 years old, after playing soccer in the afternoon of April 16, 2010, I came home in the evening with pain in my heel and could not land, so I put on anti-inflammatory and analgesic cream, and applied Fotarim, both of which were ineffective, and went to Beijing Oriental Hospital on April 18, 2010 to take an x-ray of my foot, which confirmed that it was a heel bone spur. The doctor told me to take conservative treatment first and gave me Qingpeng cream, Bone Spur Ning capsule and a kind of cream, I forgot the name, and said that if it was still like this after a week, I should have a small needle surgery, but the doctor said that the small needle can not completely guarantee the cure. The other condition was discovered a long time ago, but the symptoms were usually relieved the next day when the cream was applied, so I didn’t care, thinking it was due to muscle strain. I’ve been to the internet to find a lot of conservative treatments, and I’ve been to the internet to find the introduction of small acupuncture, although the heel bone spur has efficacy, but I think it still does not remove the bone spur ah, can have a good effect? I also want to know if this disease is treated conservatively now, will the bone spur become bigger if it recurs in the future? I like sports very much, will I be unable to play soccer in the future? I hope that the doctor can provide me with the best method to enable me to play soccer in the future. Beijing Guang’anmen Hospital Chinese Orthopedic Department Yin Yong: Heel bone spur is a common disease. However, in your case, it is a bit early to have the disease at the age of 31. This indicates a problem: you are exercising too much. This disease is usually seen in athletes at a younger age. To treat this disease, we must first clarify an anatomical fact: there is an elastic device on the bottom of the foot called the plantar tendon membrane. The metatarsal tendon membrane acts like a strong spring, maintaining the structure of the arch. The stop of the metatarsal tendon membrane in the heel is the small bone spur that protrudes on the x-ray, which is a protective growth of the body caused by the repeated pulling of the stop of the metatarsal tendon membrane by strenuous movements! The body needs to increase the local bone volume to give more attachment points for the metatarsal tendon membrane to prevent damage or even avulsion due to strain. However, the proliferation causes pain when there is pressure on the surrounding tissues. The heel spur is only a manifestation of the overstretching of the metatarsal tendon membrane and is only a result, so it is more commonly referred to as “metatarsal tendonitis” in clinical practice. The purpose of treatment for metatarsal tendonitis is not to remove the “obtrusive” small protrusion on the x-ray, because removing it will not achieve any therapeutic effect except for the aesthetic appearance on the x-ray, but will reduce the attachment force of the metatarsal tendon membrane, causing plantar pain and even flat feet. This is the difference in understanding between doctors and patients! The treatment of metatarsal tendonitis is currently divided into two parts: conservative treatment is to relieve the painful symptoms of the inflamed soft tissues caused by extrusion through oral or topical medication, and surgery is divided into minimally invasive and incisional surgery. Minimally invasive surgery includes needle and knife treatment, which does not target bone spurs, but rather the metatarsal tendon membrane where inflammation exists and is loosened. However, whether surgical or conservative treatment, avoiding strain on the metatarsal tendon membrane, in other words, reducing the amount of movement is the most important method to assist in treatment. Patient: Thank you, Dr. Yin, for your detailed explanation and answer. How should I reduce the strain? Is it true that I can’t play soccer or run and jump in sports in the future? I’ve been taking medicine for a few days to relieve the pain, but it’s still not completely relieved, and I feel sore after walking for a while. To be honest, I don’t have any other hobbies if I can’t exercise. How long will it take for me to walk and how many days will I need to take off work if I have a small needle surgery? I also read your article on how to choose shoes, and you said that I should choose “hard-soled and soft-cushioned” shoes, is it because I have been wearing sneakers and travel shoes for a long time? I think it is possible to recover through active means? Beijing Guang’anmen Hospital, Department of Traditional Chinese Medicine and Orthopedics, Yin Yong: I recommend you to choose the treatment of local closure first, the needle knife surgery needs to be operated by experienced doctors, especially pay attention to the direction of release should be parallel to the direction of the metatarsal tendon membrane, otherwise it will cause damage to the metatarsal tendon membrane! If you are not a professional athlete, I suggest you better reduce the amount of physical activity because common orthopedic degenerations such as neck, shoulder, waist and leg are often caused by strain. Even after treatment with local closure, needle surgery, or even incisional surgery, there is still a need to reduce the amount of activity! This is a must!!! Patient: Thank you, Dr. Yin.