Heel Spurs: Causes, Symptoms, and Treatments

Heel Spurs And Their Treatment Options

Heel spurs are considered by many a common cause of heel pain. They develop over time and may go unnoticed in the background until the onset discomfort and imaging reveals a spur. If you’re experiencing sharp pain in your heel, especially on weight bearing, a heel spur might be a contributing reason. Lets explore what heel spurs are, how they differ from other foot conditions, and how to manage the pain associated with them.

What Are Heel Spurs?

A heel spur is a calcium deposit that causes a bony protrusion on the underside of the heel bone. Size can vary, however the typically measure a few or more millimeters. Heel spurs form when load damages the heel bone membrane. Repeated stress to the membrane that covers the heel bone can trigger the body to deposit calcium as part of the adaptive healing process. Over time, this buildup can form a spur.

The presence of a spur is not uncommon and many, probably the majority are  asymptomatic. Regularly seen on imaging when having a foot or ankle X-ray for other reasons.

What Are the Symptoms of a Heel Spur?

The most common symptom associated with a spur is heel pain. Especially during the first steps in the morning or after long periods of rest. Described by some when severe as a stabbing pain into the heel. As the day progresses, the pain may dull but continue throughout weight bearing activities.

It’s important to note that heel spurs themselves may not be the cause of pain. Often, it is the soft tissues around the spur that are responsible for the discomfort.

What Is the Difference Between a Heel Spur and Plantar Fasciitis?

Plantar fasciitis is inflammation of the plantar fascia, a thick band of tissue running across the bottom of the foot. This condition often coexists with heel spurs but is not the same. While plantar fasciitis affects the soft tissue, heel spurs are actual bony growths.

Heel pain from plantar fasciitis usually starts before the presence of a heel spur. Many diagnosed with heel spurs may well have experienced plantar fasciitis prior to developing the spur. Research published in the Journal of Foot and Ankle Research suggests that while many people with plantar fasciitis develop heel spurs, not all with spurs have symptoms. Spurs could be considered an indication of an active life, with substantial weight bearing activity throughout life. They are certainly not a guarantee the individual will be experiencing pain, or even develop pain at a later point.

What Happens If Bone Spurs Are Left Untreated?

Untreated symptomatic heel spurs may make everyday activities uncomfortable as would plantar fascia pain. While they do not typically break or cause any systemic issues, they can affect your overall mobility and quality of life for the period of time they are symptomatic.

Do They Remove a Heel Spur?

Treatment depends on the severity of symptoms. Conservative treatment options usually work for the majority of people. Historically heel spurs many moons ago were removed. However these days it is a rarity. As a rule, simple treatment targeting off loading the soft tissue around the spur, promoting soft tissue healing will achieve more than satisfactory results:

• Relative rest and ice therapy to manage symptoms
• Orthotic inserts and supportive footwear to off load the painful area and reduce loading stress to the plantar fascia and spur.
• Physiotherapy and appropriate strengthening (and sometimes stretching exercises)
• Shockwave therapy and laser therapy to desensitize pain and promote blood flow.
• Anti-inflammatory medications to help manage symptoms
• Corticosteroid or PRP injections for stubborn conditions not responding to conservative methods. 

What Happens If You Keep Walking on a Heel Spur?

Continuing to walk on a symptomatic heel spur can aggravate the pain. The pressure placed on the heel during walking may increase irritation to the surrounding tissues. Over time, this pain may worsen, and compensatory movement can strain other parts of the body, as well as have a negative impact on health due to reduced activity levels.

Why Are Heel Spurs So Painful?

Heel spurs themselves are not always painful. The pain comes from the soft tissues around the spur. When the plantar fascia pulls on the heel bone, it can cause irritation. Inflammation and micro-tears in the tissue are what typically lead to the sharp, stabbing pain many experience and relate to their spur.

In some cases, the spur presses/compresses into the neighboring soft tissues, irritating the area further. It is this situation that may make the presence of the spur relevant when someone is suffering with plantar fascia pain.

Can Heel Spurs Ever Go Away?

Heel spurs do not disappear on their own. The calcium deposits remain, however, the symptoms can go away. Many people find relief through consistent use of conservative treatments. By reducing any inflammation and addressing biomechanical causes, off loading the painful tissues the heel can become pain-free even with the spur still present. Some individuals experience recurring symptoms, yet many are able to manage the condition long-term without ever resorting to invasive procedures.

Heel spurs are a common foot condition that can cause discomfort and interfere with daily life. They often result from chronic loading on the foot and heel area associated with plantar fasciitis. While the bony spur itself isn’t always the source of pain, irritation and inflammation in surrounding tissues can be quite debilitating.

Early management through proper footwear, and care can reduce the impact plantar fascia pain and heel spurs have on your life. If you’re dealing with persistent heel pain, consult a physiotherapist or podiatrist for a personalized treatment plan.