Heel spurs are bony growths that form on the heel bone, sometimes leading to discomfort. These growths are a common finding, often discovered incidentally during X-rays for other foot conditions. This article explores what heel spurs are, their typical locations, how they develop, and their symptoms.
Understanding Heel Spurs
A heel spur, also known as a calcaneal spur or osteophyte, is a calcium deposit forming a bony protrusion on the heel bone. It can appear as a small spike, hook, or shelf-like shape, some growing up to half an inch. While often associated with pain, the spur itself is frequently asymptomatic; many individuals have them without pain.
Precise Location of Heel Spurs
Heel spurs primarily form on the calcaneus, the largest bone in the foot. The most common location for these growths is on the underside of the heel bone, extending towards the arch. Specifically, this inferior (bottom) type of heel spur develops where the plantar fascia, a thick band of tissue, attaches to the medial tubercle of the calcaneus. The plantar fascia runs along the bottom of the foot, connecting the heel bone to the toes and supporting the arch.
Less commonly, heel spurs also form on the back of the heel, known as a posterior or dorsal heel spur. These typically develop at the insertion point of the Achilles tendon onto the calcaneus. The Achilles tendon connects the calf muscles to the heel bone. While both types are bony growths, the plantar heel spur is far more prevalent and is often linked to plantar fasciitis.
How Heel Spurs Develop
Heel spurs develop gradually from chronic strain and repetitive stress on the foot’s muscles and ligaments, particularly the plantar fascia. This prolonged tension can lead to micro-tears and inflammation at the soft tissue attachment points on the heel. The body responds to this ongoing stress by depositing calcium to repair the damaged area. Over time, these calcium deposits accumulate and calcify, forming the bony protrusion known as a heel spur.
Several factors increase the likelihood of heel spur formation. Repetitive high-impact activities like running, jumping, or prolonged standing on hard surfaces contribute to chronic stress on the heel. Improper footwear lacking adequate arch support or cushioning also place undue strain on the foot. Other contributing factors include excess body weight, increasing pressure on the foot, and gait abnormalities that create uneven weight distribution.
Recognizing Heel Spur Symptoms
Symptoms associated with heel spurs typically involve pain and tenderness in the heel area. This pain is often described as sharp or stabbing, like stepping on a knife or pin, especially with the first steps in the morning or after periods of rest. The pain may lessen with continued activity as the tissues warm up, but it can return or worsen after prolonged standing, walking, or increased activity.
Along with pain, individuals might experience inflammation and swelling at the front or bottom of the heel. The affected area may also feel warm to the touch. The pain is usually not caused by the spur itself piercing tissues, but rather by the inflammation of the soft tissues, such as the plantar fascia, where the spur has formed. Therefore, managing the underlying inflammation is a primary focus in addressing heel spur-related discomfort.