What are Heel Spurs? A Podiatrist Explains the Causes and Treatment
Share
A podiatrist explains what heel spurs are, why they form, and how the right support eases the pain.
By Sophie McLellan, Co-Owner & Podiatrist, Little Big Feet Podiatry, Brisbane
Key Facts
- What it isA bony outgrowth (osteophyte) on the heel bone, visible only on x-ray, that builds up gradually over months or years.
- Most at riskPeople with untreated plantar fasciitis, those in unsupportive footwear, runners and jumpers, and people with excess weight, diabetes or ageing connective tissue.
- Common symptomsOften none. When symptomatic, sharp, dull or throbbing heel pain, local inflammation, pain walking barefoot, and sometimes numbness or tingling.
- Primary treatmentSupportive footwear and orthotic therapy, with options like shockwave therapy, night splints, compression socks, strapping and dry needling for stubborn cases.
What are heel spurs?
'Heel spurs' has become a common term that people often use incorrectly to describe heel pain. A much more common cause of heel pain is in fact Plantar Fasciitis. Heel spurs are an osteophyte, or bony outgrowth (hook or spike shape) that originates and extends forward from the heel bone. They can only be seen on x-ray and build up gradually over many months or years.
Spurs can develop anywhere in the body where tendons attach to a bone. Heel spurs tend to be asymptomatic, however some people with other heel pain symptomology (such as Plantar Fasciitis) may have a presence of a spur.
If in fact, a heel spur is symptomatic, they may aggravate the surrounding tissue and may result in symptoms such as:
- Pain or tenderness in the heel of the affected foot which can feel sharp, dull or may throb
- Local inflammation at the bottom of the heel
- Pain when walking or exercising barefoot (or without support)
- On occasion, numbness, burning and tingling if there is nerve involvement
What causes a heel spur?
Heel spurs commonly develop in response to damage or strain of the soft tissues that inserts at the bottom of the heel - in this case, the plantar fascia tissue.
Micro trauma is caused when the connecting Plantar Fascia repeatedly pulls on the origin of the heel bone. The body responds by trying to repair the area by laying more bone - these calcified protrusions are what we refer to as the spurs. Anything that exacerbates the pulling of the fascia on the calcaneus (heel bone) will contribute to a spur's formation.
For example: unsupportive footwear, repetitive stress (jumping/running) without support, overuse/overtraining on the fascia, muscle imbalances, rigid or inflexible feet that cannot adequately absorb impact. Diabetes, excess weight and changes in connective tissue with age may also contribute to heel spurs.
How are heel spurs treated?
If you suspect heel spurs, you should consult with your podiatrist for a proper diagnosis. Treatment will vary depending on the underlying causative factors but may include:
- Supportive footwear
- Orthotic therapy
- Shockwave therapy
- Night splints & cam walkers
- Compression & support socks
- Strapping
- Dry needling
- Pain relief medication
The Comfort Co Breakdown
Heel spurs, in plainer English
Think of a heel spur as a tiny bony hook or spike growing out of your heel bone. It does not appear overnight. It is actually your body trying to protect itself. The most common trigger is prolonged, untreated plantar fasciitis: the thick band of tissue under your foot keeps pulling and straining at your heel bone, so your body lays down calcium to anchor it. That little calcium bridge is the spur.2
Why is this happening?
All-day impact. Standing or walking on hard surfaces such as tiles, concrete or floorboards for hours means thousands of tiny micro-impacts, and over years the body can reinforce the heel with a spur.
Weight gain. Extra body weight puts more vertical pressure on the heel with every step, and the body can build a spur to help handle the load.
Ageing. The natural fat pad on the bottom of the heel thins over time, so the bone takes more of the hit.
Arch issues. Flat feet or very high arches spread your weight unevenly, creating hot spots of pressure that can trigger bone growth.
Inflammatory conditions. Osteoarthritis and some types of arthritis can prompt the body to grow extra bone near joints.
What happens if I ignore it?
While the spur itself may not always hurt, it is a permanent sign your feet have been working too hard without the right support. By the time a spur shows up on an x-ray, that tug-of-war has usually been going on for months or even years. Settle the plantar fascia early and you can often stop the pain without the spur ever becoming a problem.1
Written by The Comfort Co team.
The Comfort Co Solutions
The bad news is that once that little bony hook is there, it tends to stay. The good news is you can usually stop the pain by changing the environment your heel lives in and ending the tug-of-war that caused the spur in the first place.
1. Arch support
Heel spurs often follow untreated plantar fasciitis, so the first goal is to stop the tissue pulling on the bone. Supporting the arch shortens the distance the tissue has to stretch and eases the constant pulling at the source. Start with the arch support collection, and if you have a favourite pair with no support, a pair of orthotic insoles can change the mechanics of the foot and give the heel some breathing room.
2. Cushioning
If you have a bony spike on your heel, the last thing you want is to slam it into hard ground. You need a soft landing for your foot. The Vitasole range is built for high-rebound cushioning thanks to its EVA foam, which absorbs that initial thud when your heel hits the ground so the spur is not rattled with every step.
3. The no-barefoot rule
Walking barefoot on tiles or floorboards, especially first thing in the morning, is the quickest way to make a heel spur flare up. Keep a pair of supportive slippers next to your bed and put them on the second you stand up, so your heel is supported and cushioned from the very first step of the day.
4. Calm the inflammation
Sometimes it is not the bone that hurts but the angry, swollen tissue around it. A good pair of compression or support socks from OS1st can help manage that throbbing feeling by keeping blood flowing and inflammation down.
Comfort Co Pro Tip
If you are feeling that sharp stone-in-my-shoe pain, try the frozen water bottle trick. Roll your heel over a frozen bottle for ten minutes at night to settle the inflammation around the spur. It feels wonderful after a long day on your feet.
Keep Reading
Quick questions
Are heel spurs and plantar fasciitis the same thing?
No. A heel spur is a bony growth on the heel bone, while plantar fasciitis is inflammation of the tissue under the foot. They often occur together, and plantar fasciitis is a far more common cause of heel pain.
Do heel spurs always hurt?
No. Many heel spurs are asymptomatic and are only found on x-ray. When there is pain, it usually comes from the surrounding inflamed tissue rather than the spur itself.
Can heel spurs go away on their own?
No. Once a spur has formed it does not dissolve, but the pain around it can usually be settled with supportive footwear, orthotics, cushioning and reduced strain on the plantar fascia.
What shoes are best for heel spurs?
Shoes with firm arch support and a cushioned heel take strain off the plantar fascia and soften each step. A supportive insole added to shoes you already own can help as well.
Should you walk barefoot with heel spurs?
It is best avoided, especially first thing in the morning on hard floors. Supportive shoes or slippers from the first step protect the heel and reduce flare-ups.
Sources
- Cleveland Clinic. Heel Spurs. my.clevelandclinic.org
- OrthoInfo, American Academy of Orthopaedic Surgeons. Plantar Fasciitis and Bone Spurs. orthoinfo.aaos.org