What Are Heel Spurs?
A heel spur is a calcium deposit that forms a bony protrusion on the underside
of the heel bone (calcaneus). They develop over months as calcium deposits build
up on the bottom of the heel bone.
Here's what many people don't realize: heel spurs themselves often don't cause
pain. Many people have heel spurs with no symptoms at all. When heel pain does
occur, it's usually due to the soft tissue conditions associated with the spur -
particularly plantar fasciitis - rather
than the spur itself.
The Heel Spur-Plantar Fasciitis Connection
Heel spurs frequently occur alongside plantar fasciitis. The repeated stress
and inflammation that causes plantar fasciitis also stimulates bone growth
where the plantar fascia attaches to the heel bone. This is why:
- About 50% of people with plantar fasciitis have heel spurs
- Many people with heel spurs (visible on X-ray) have no heel pain
- Treating plantar fasciitis often resolves the pain - without removing the spur
Symptoms
- Sharp pain in the heel, especially with first steps in the morning
- A dull ache in the heel throughout the day
- Inflammation and swelling at the bottom of the heel
- Pain that worsens after prolonged rest
- Pain after (not during) exercise
- A small, visible bony protrusion (in some cases)
Note: These symptoms are often identical to plantar fasciitis symptoms because
they frequently occur together.
Causes and Risk Factors
- Plantar Fasciitis: Long-standing inflammation at the fascia attachment
- Abnormal Gait: Walking patterns that put extra stress on the heel
- Running or Jogging: Especially on hard surfaces
- Poorly Fitting Shoes: Inadequate arch support or cushioning
- Excess Weight: Increased stress on the heel
- Age: More common in middle-aged and older adults
- Flat Feet or High Arches: Altered foot mechanics
- Standing Occupations: Teachers, nurses, factory workers
Diagnosis
- Physical Examination: Checking for pain, tenderness, and inflammation
- X-rays: Heel spurs are visible on X-ray, often discovered incidentally
- Medical History: Understanding symptom patterns and risk factors
Remember: Finding a heel spur on X-ray doesn't mean it's the cause of your pain.
Dr. Johnson will evaluate the whole picture to determine what's really going on.
Treatment Options
Since heel spurs themselves rarely cause pain, treatment focuses on the
underlying condition (usually plantar fasciitis):
Non-Surgical Treatment
- Stretching Exercises: For the plantar fascia and calf muscles
- Custom Orthotics: Supporting the arch and redistributing pressure
- Proper Footwear: Shoes with good cushioning and arch support
- Ice: Rolling a frozen water bottle under the foot
- Rest: Reducing activities that aggravate symptoms
- Night Splints: Maintaining stretch while sleeping
- Anti-inflammatory Medications: Short-term pain relief
- Corticosteroid Injections: Targeted inflammation relief
- Physical Therapy: Guided rehabilitation
- Shockwave Therapy: Stimulating healing
Surgical Treatment
Surgery is rarely needed and only considered after conservative treatments
have failed for 6-12 months. When surgery is necessary, it typically involves:
- Plantar Fascia Release: Relieving tension on the fascia
- Heel Spur Removal: Sometimes performed along with fascia release
Importantly, removing the spur alone often doesn't resolve symptoms if the
underlying soft tissue problem isn't addressed.
Prevention
- Wear supportive, well-fitted shoes
- Stretch your feet and calves regularly
- Maintain a healthy weight
- Don't ignore early signs of heel pain
- Replace worn athletic shoes
- Warm up before exercise