A heel spur is a common foot condition, a bony protrusion or calcium deposit that forms on the underside of the heel bone. While often associated with heel pain, the spur itself is not always the direct cause of discomfort.
What a Heel Spur Is
A heel spur is a bony outgrowth of calcium deposits, typically extending from the underside of the heel bone (calcaneus) towards the arch. These spurs can reach half an inch. They form where the plantar fascia, a thick tissue band along the foot’s bottom, connects to the heel bone.
Heel spurs form from chronic strain and inflammation in the foot’s soft tissues, especially the plantar fascia. Repeated pulling on the heel bone creates micro-trauma. The body repairs this by laying down new bone tissue, forming hardened calcium deposits. The most common type is on the sole of the foot.
Causes and Symptoms
Heel spurs develop from chronic stress and strain on foot muscles and ligaments, often associated with plantar fasciitis. Repetitive activities like running, jogging, or prolonged standing on hard surfaces contribute to this strain. Improper footwear lacking arch support or cushioning also places excessive stress on the heel.
Other factors increasing heel spur risk include gait abnormalities, excess body weight, and increasing age, which reduces plantar fascia flexibility and thins the heel’s protective fat pad. Medical conditions like arthritis and diabetes may also raise the risk.
Many heel spurs cause no symptoms and are discovered incidentally on X-rays. However, they can cause discomfort. Symptomatic signs include sharp or stabbing heel pain, especially with first steps in the morning or after rest. Pain may ease with walking but can return after prolonged activity or rest. Tenderness, inflammation, and swelling at the front of the heel can also occur.
Diagnosis and Treatment
Diagnosing a heel spur involves a physical examination and imaging tests. A healthcare provider examines the foot for tenderness, swelling, and assesses gait. An X-ray confirms the bony growth, though symptoms help determine if pain relates to associated conditions like plantar fasciitis.
Treatment for heel spurs focuses on conservative, non-surgical methods to reduce pain and inflammation. These include rest, ice application, and stretching exercises targeting the plantar fascia and calf muscles. Proper footwear with arch support, orthotic inserts, or heel cups can alleviate pressure and provide cushioning.
Over-the-counter anti-inflammatory medications, such as ibuprofen, may manage pain and inflammation. Physical therapy provides exercises to strengthen foot muscles and improve flexibility. For persistent symptoms, corticosteroid injections or shockwave therapy, which uses pressure waves to stimulate healing, may be considered. Surgery to remove the spur or release the plantar fascia is rarely needed, reserved for cases where conservative treatments have not provided relief after 9 to 12 months.
Prevention
Preventing heel spurs involves reducing foot strain and maintaining overall foot health. Wear supportive shoes with adequate arch support and shock-absorbent soles. Athletic shoes should be appropriate for the specific activity, and regularly replace worn-out footwear.
Consistent stretching of calf muscles and plantar fascia helps maintain flexibility and reduce heel tension. Maintaining a healthy weight minimizes load and pressure on the feet. Warming up before exercise, gradually increasing activity, and avoiding pushing through heel pain can prevent spur development or worsening.