A heel spur, also known as a calcaneal spur, is a bony projection that develops along the underside of the heel bone at the point where the plantar fascia attaches. It forms gradually over time as a response to repeated stress on the heel.

The plantar fascia is a thick band of connective tissue that runs from the heel to the ball of the foot. When this structure is placed under ongoing strain, the body may form extra bone at its attachment site.

On X-ray, a heel spur appears as a small hook-like or shelf-like extension of bone. It is a common condition and affects approx 15% of individuals.

Most heel spurs are painless. However, they are frequently associated with plantar fasciitis, an inflammatory condition that can cause significant heel pain.

The following factors are associated with the development of a heel pain spur:

• Strain on foot muscles and ligaments
• Repeated stretching of the plantar fascia
• Ongoing tearing of the membrane that covers the heel bone
• Activities involving frequent running and jumping, especially in athletes
• Walking gait abnormalities that place excessive stress on the heel bone, ligaments, and nearby nerves
• Running or jogging on hard surfaces
• Poorly fitted or worn-out footwear, particularly shoes lacking proper arch support
• Excess body weight and obesity

Are There Additional Risk Factors?

Yes. Several factors linked to plantar fascia stress may also increase the likelihood of a heel bone spur:

• Increasing age, which reduces plantar fascia flexibility and thins the protective fat pad under the heel
• Diabetes
• Spending most of the day on the feet
• Frequent short bursts of physical activity
• Having flat feet or high arches

Because heel spurs develop gradually, symptoms may not appear immediately. In many cases, treatment focuses on relieving soft tissue strain and addressing contributing factors rather than the bony growth itself.

Appropriate heel spur treatment is based on a careful evaluation of the source of heel pain and the underlying mechanical stress.

Heel spurs often cause no symptoms. In many cases, a heel spur is present without causing discomfort.

When symptoms do occur, they are usually related to inflammation in the tissues surrounding the spur rather than the bony growth itself. Pain may be intermittent or chronic and is commonly noticed during walking, jogging, or running.

The discomfort is frequently described as a sharp, stabbing sensation, similar to a knife or pin pressing into the bottom of the heel. The pain is typically most intense with the first steps in the morning.

As movement continues, the sharp pain may lessen and change into a dull ache. However, the sharp discomfort often returns after standing up following a prolonged period of sitting.

Because the pain pattern closely resembles plantar fasciitis, careful evaluation is necessary to determine whether the symptoms are due to soft tissue inflammation, a heel spur, or a combination of both.

Heel spur treatment focuses on reducing pain and addressing inflammation in the surrounding tissues. 

If heel pain persists for more than one month, consultation with a healthcare provider is recommended. Conservative treatment options may include:

• Stretching exercises
• Strapping or tapping to rest stressed muscles and tendons
• Shoe recommendations
• Orthotic devices or Shoe inserts 
• Night splints
• Physical therapy
• Over-the-counter medications
• Functional orthotic devices to address biomechanical imbalances
• Corticosteroid injection to relieve inflammation in the affected area
• Laser therapy
  
  
• Extracorporeal shock wave therapy (ESWT)

More than 90 percent of individuals improve with non-surgical treatment.

If symptoms continue after 9 to 12 months despite conservative care, surgery may be necessary to relieve pain and restore mobility. Surgical options include:

• Partial removal of the spur
  
  
• Release of the plantar fascia
  
  
• TenJet procedure
  
  
• Regenerative medicine treatments

Heel pain can disrupt your daily routine and limit your comfort. If you or someone close to you is struggling with this condition, schedule an appointment with Central Florida Foot and Ankle Center, LLC. Same-day visits are available at our Winter Haven, Lakeland, and Davenport, FL locations. 

Call now to get the care you need and start moving comfortably again.