A heel spur is a calcium deposit that forms on the underside of the heel bone (calcaneus). This bony protrusion often develops due to chronic stress, particularly from the pulling of the plantar fascia ligament, and is associated with plantar fasciitis. While the spur itself may not always cause pain, surgery is considered when persistent discomfort remains after all other options have failed. Modern surgical methods minimize pain during the operation, but some level of post-operative discomfort is a temporary and expected part of the healing process.
When Surgery Becomes Necessary
The decision to pursue surgery for a heel spur is typically reserved as a last-resort option after a prolonged course of failed non-surgical treatments. Most individuals find relief through conservative measures, which include rest, stretching exercises, and the use of custom orthotic devices to support the foot’s arch. Physical therapy and corticosteroid injections are also common interventions used to reduce inflammation and pain in the heel.
A surgeon usually considers intervention only after chronic, debilitating heel pain has persisted for six to twelve months despite adherence to non-operative treatments. The procedure often involves removing the bone spur and performing a partial release of the plantar fascia ligament (plantar fasciotomy). This release reduces the tension that contributed to the spur’s formation, offering a viable path toward long-term relief when conservative efforts fail.
Anesthesia and Pain During the Operation
Patients feel no pain during the actual surgical procedure due to the use of anesthesia. Heel spur surgery is commonly performed as an outpatient procedure, allowing the patient to return home the same day. The type of anesthesia varies based on the patient’s health and the surgeon’s preference, but it ensures a pain-free experience during the operation.
One common choice is a regional anesthetic block, which involves injecting a numbing agent near the leg nerves to desensitize the foot for the surgery and several hours afterward. Alternatively, the procedure may use local anesthesia combined with intravenous sedation, sometimes called “twilight sleep.” General anesthesia may be used in some cases, especially if other procedures are done concurrently, to keep the patient completely unconscious.
Immediate Post-Operative Pain Management
The acute pain phase begins as the anesthetic block wears off, typically within the first 24 to 72 hours following the procedure. During this time, the medical team implements a multimodal approach to manage discomfort, which involves a combination of prescription and non-prescription medications. Opioid pain relievers may be prescribed for short-term use during the initial days when pain is at its highest, but they are often paired with non-opioid medications.
Patients are instructed to take non-steroidal anti-inflammatory drugs (NSAIDs) and acetaminophen on a scheduled basis to control pain and inflammation. Non-pharmacological strategies are also a substantial part of the immediate recovery plan. Applying ice packs and keeping the foot elevated above the heart are essential actions that help reduce swelling and throbbing discomfort. Adhering to the prescribed rest and elevation schedule is important for minimizing initial post-operative pain.
The Extended Recovery and Rehabilitation Timeline
After the initial acute pain subsides, the focus shifts to managing discomfort associated with healing and regaining mobility. For the first two to four weeks, most patients must limit weight-bearing, often relying on crutches or a knee scooter. During this phase, pain is typically less sharp, but swelling, stiffness, and a persistent ache are common sensations.
A surgeon will gradually transition the patient to a protective walking boot, allowing for partial weight-bearing and a slow return to daily activities around four to six weeks post-operation. Physical therapy usually begins during this transition and is important for managing stiffness and restoring the foot’s range of motion. Therapy exercises focus on stretching the calf muscles and Achilles tendon, which helps reduce tension on the healing plantar fascia.
Total recovery time can range from two to six months, depending on the individual and the extent of the surgery. As the incision heals and swelling subsides, discomfort changes from acute pain to stiffness and a dull ache after activity. Consistent physical therapy and following guidelines for progressive weight-bearing are necessary steps that lead to the resolution of chronic pain.