A heel spur is a bony projection that forms on the underside of the heel bone, known as the calcaneus. This condition is essentially a calcium deposit that builds up over many months or years in response to chronic strain on the foot muscles and ligaments. The primary question for anyone experiencing this foot pain is whether this bony growth will disappear without medical intervention. While the pain associated with a heel spur often resolves, the actual bone structure itself does not typically dissolve on its own.
Understanding Heel Spurs
A heel spur is a small, hook-like growth composed of calcium that protrudes from the heel bone, known as the calcaneus. This formation often develops where the plantar fascia, a long, thick band of tissue running along the bottom of the foot, attaches to the heel. Heel spurs are a reaction by the body to repeated stress, such as chronic stretching of the plantar fascia or repeated tearing of the membrane covering the heel bone.
Many people have heel spurs that cause no symptoms at all, only discovering them incidentally on an X-ray. The pain typically associated with a heel spur is almost always caused by inflammation and injury to the surrounding soft tissues, most commonly the plantar fascia (a condition called plantar fasciitis).
Symptoms often include a sharp, stabbing pain in the heel, which is usually most intense with the first steps taken in the morning or after a period of rest. This discomfort may lessen as the person walks, only to return as a dull ache after prolonged standing or activity. The pain is a result of the tissue strain that caused the spur to form, not the spur itself.
The Natural Course and Prognosis
The bony protrusion of a heel spur, being a hardened calcium deposit, does not dissolve naturally once it has formed. The physical presence of the spur remains, even if all pain symptoms disappear. Since the spur itself is usually not the source of the discomfort, its permanence does not prevent a person from achieving full relief.
The painful inflammation in the soft tissue often resolves over time. More than 90% of patients find relief from heel pain through simple, non-invasive methods within six to twelve months. This recovery is a result of the inflamed plantar fascia healing, which reduces the tension and irritation around the heel bone.
Management focuses on treating the underlying plantar fasciitis and reducing the strain that caused the bone growth. By addressing the soft tissue inflammation, the symptoms subside, even though the spur remains visible on an X-ray. The prognosis for pain relief is excellent, but it requires consistent effort and patience with conservative care.
Non-Surgical Management and Relief
Conservative treatments are highly effective and are the first line of defense against heel spur-related pain.
Rest and Activity Modification
One of the most immediate strategies is incorporating rest and activity modification to reduce strain on the affected foot. Limiting high-impact activities like running or jumping and reducing the time spent standing can provide the necessary time for the soft tissues to heal.
Stretching and Flexibility
Targeted stretching exercises are beneficial for increasing the flexibility of the plantar fascia and calf muscles, which reduces the pull on the heel bone. A specific stretch involves sitting and pulling the toes of the affected foot back toward the shin, holding the stretch for about 30 seconds and repeating it several times. Calf stretches, done by leaning against a wall with one leg back and the heel flat, also help to lengthen the tight muscles that contribute to the strain.
Cold Therapy
Cold therapy helps to reduce inflammation and numb the area, providing immediate relief from pain. Rolling the foot over a frozen water bottle for 15 to 20 minutes, three to four times a day, is an effective way to apply cold directly to the irritated tissue. This application should be performed after activity or when pain flares up.
Footwear and Support
Proper footwear is another component of non-surgical care, as shoes should offer firm heel support and adequate cushioning. Over-the-counter arch supports or heel cushions can also be used inside shoes to redistribute pressure and absorb shock, minimizing the tension on the plantar fascia. Look for shoes that are moderately flexible but not easily collapsible, and consider a slight heel elevation.
When Professional Intervention is Needed
If conservative measures do not provide adequate relief after several weeks or months, a medical professional should be consulted for a formal diagnosis and advanced treatment plan. A doctor can use an X-ray to confirm the presence of the heel spur and rule out other potential causes of heel pain, such as a stress fracture. This imaging allows the healthcare provider to assess the extent of the bony growth.
Treatments requiring a doctor’s oversight include:
- Prescription-strength nonsteroidal anti-inflammatory drugs (NSAIDs) to manage persistent pain and inflammation.
- Corticosteroid injections delivered directly into the affected area for severe, localized inflammation, providing temporary relief.
- A formal physical therapy program, which provides specialized exercises and techniques to improve foot mechanics and strength.
- Custom-molded orthotics, which are inserts designed to correct gait abnormalities and foot structure, offering superior support compared to over-the-counter options.
Surgery is considered a last resort and is rarely necessary, as most people respond well to non-surgical treatment. It is typically reserved for cases where pain has not improved after a full course of conservative care lasting six to twelve months. The surgical procedure may involve removing the spur or releasing the tension in the plantar fascia.