What a heel spur is
A heel spur (calcaneal spur) is a deposit of bone that builds up over months or years where tendons or fascia pull on the heel bone. The most common type sits underneath the heel, at the origin of the plantar fascia, the thick band that supports the arch. A second type forms at the back of the heel, where the Achilles tendon attaches.
Spurs are a sign of long-term traction and are more common with age. On their own they are often harmless; the pain people feel usually comes from inflammation and degeneration of the fascia or tendon nearby.
Symptoms
- Sharp or stabbing pain under the heel with the first steps in the morning or after sitting.
- Pain that eases after walking for a few minutes and returns after long standing or activity.
- Tenderness when pressing under the front of the heel.
- Pain at the back of the heel, with stiffness, in spurs related to the Achilles tendon.
- No symptoms at all in many people.
See also plantar fasciitis symptoms and pain in the bottom of the foot.
Causes and risk factors
- Long periods of standing or walking on hard surfaces.
- Running and jumping, especially with a sudden increase in training.
- Tight calf muscles and Achilles tendon.
- Flat feet or high arches that change how load passes through the foot.
- Excess body weight.
- Unsupportive or worn-out footwear.
- Age over 40, and conditions such as inflammatory arthritis.
How it is diagnosed
Diagnosis of heel pain is mainly clinical: a physiotherapist or doctor asks about the pattern of pain and examines the foot, calf flexibility and walking. An X-ray shows the spur but is not needed for most people with typical plantar heel pain. Imaging is useful when pain does not improve, when there is swelling, numbness or night pain, or when a stress fracture or other cause is suspected.
Treatment that works
- Stretching: calf stretches against a wall and plantar fascia stretches (pulling the toes back) several times a day, especially before the first steps of the morning.
- Strengthening: slow heel raises, progressing to raises with the toes on a rolled towel to load the plantar fascia, plus foot muscle exercises.
- Footwear: cushioned, supportive shoes with a slight heel; avoid walking barefoot on hard floors and very flat shoes.
- Insoles and heel cups: soft heel pads or arch supports reduce pressure.
- Load management: temporarily reduce running and long standing, and use cycling or swimming to stay active.
- Pain relief: ice for 10 to 15 minutes and short courses of anti-inflammatory medication if suitable.
- Night splints to keep the foot stretched overnight in some cases.
See also foot arch pain.
A simple daily routine
- Before getting up: pull the toes back towards you for 30 seconds, three times.
- Roll the sole of the foot over a cold bottle or ball for one to two minutes.
- Calf stretch against a wall, knee straight and then bent, 30 seconds each, three times.
- Heel raises on a step, slowly up and down, 3 sets of 10 to 15, progressing gradually.
- Towel scrunches with the toes for foot strength.
Mild discomfort during exercises is acceptable, but pain should settle within 24 hours.
If pain persists
- Extracorporeal shockwave therapy can help long-standing plantar heel pain.
- Steroid injections may give short-term relief but carry a small risk of fat pad thinning or fascia rupture, so they are used sparingly.
- Custom orthotics may help selected foot shapes.
- Surgery to release the plantar fascia or remove a spur is considered only after 6 to 12 months of well-done conservative treatment.
When to see a doctor
- Heel pain after a fall or injury, or inability to bear weight.
- Swelling, redness, warmth or fever.
- Numbness, tingling or burning in the foot.
- Pain at night or at rest.
- Pain in both heels with joint pain elsewhere or morning stiffness of the back.
- No improvement after several weeks of self-care.
Key points to remember
- Heel spurs are common and often painless.
- Pain usually comes from the plantar fascia, not the spur itself.
- Stretching, strengthening, footwear and insoles help most people within months.
- Surgery is rarely needed.
Questions about heel spurs
These answers are general information and do not replace an examination or individual medical advice.
Do heel spurs go away?
The bone spur usually stays, but the pain often settles completely with treatment of the surrounding soft tissues.
What is the difference between a heel spur and plantar fasciitis?
A heel spur is a bony growth seen on X-ray. Plantar fasciitis is irritation of the fascia that usually causes the pain.
What is the fastest way to heal a heel spur?
Daily stretches, gradual strengthening, supportive shoes, heel cushions and reducing high-impact activity give the best results.
Should I walk with a heel spur?
Yes, within comfort. Reduce long walks and running temporarily, and keep active with low-impact exercise.
Are heel spurs caused by calcium in the diet?
No. They are caused by long-term mechanical strain, not by dietary calcium.
When is surgery needed for a heel spur?
Only rarely, after 6 to 12 months of conservative treatment without improvement.
Sources
This guide is for general information and does not replace medical advice. How a problem is diagnosed and treated depends on your examination and medical history. If you think you have an emergency, contact your local emergency services.