Heel Spurs

A heel spur is a small bony growth on the heel bone, usually on the underside where the plantar fascia attaches, or at the back of the heel where the Achilles tendon attaches. Many people have a heel spur without any pain at all. When it does hurt, the pain usually comes from inflammation of the surrounding soft tissue, so the right treatment is aimed at the cause rather than the spur itself.

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Symptoms

A sharp pain under the heel, often described as like standing on a stone or a pin
Pain that is worse when you first get up in the morning, or after sitting or resting
A dull ache in the heel that builds up through the day, especially after long periods of standing or walking
Tenderness when pressing on the bottom or back of the heel
Sometimes a small, firm lump at the back of the heel

Common causes

Long-term strain on the plantar fascia, the band of tissue under the foot, where it pulls on the heel bone
Flat or high arched feet
Faulty foot biomechanics, for example feet that do not function correctly or efficiently when walking or running
Tight calf muscles and Achilles tendon
Long periods of standing or walking on hard surfaces
Unsupportive footwear, especially worn-out shoes, pumps and flip flops
Weight gain, which increases the load on the heel
Age, as the fat pad under the heel naturally thins over time

What else can look similar

Plantar fasciitis
Achilles tendinopathy
Heel fat pad syndrome
Bursitis of the heel
Stress fracture of the heel bone
Nerve entrapment, such as tarsal tunnel syndrome
Arthritis

What you can try at home

Pain killers such as paracetamol
Cold compresses or ice on the heel after activity
Gentle calf stretches, and using a foot roller under the arch
Wear supportive, cushioned footwear with a slight heel, and avoid going barefoot
Reduce long periods of standing or high-impact exercise until the pain settles
If heel pain is ongoing or recurring, it needs a professional podiatry assessment and diagnosis

How we can help

A physical examination and a clear diagnosis. Not all heel pain is caused by a heel spur, and a spur seen on an X-ray is not always the source of the pain
Expert strapping to offload the heel if needed
Exercises to stretch and strengthen the feet and lower legs, under the guidance of an HCPC registered podiatrist
Specific footwear advice to ease the pain and prevent it returning
A biomechanical assessment to find the underlying causes of your pain
Heel cups, padding and footwear modifications
Foot orthoses, ranging from off the shelf and semi bespoke to tailor made
Cortisone (steroid) injections, where appropriate. These are rarely needed
Acupuncture
Referral for an X-ray, scan or orthopaedic opinion in severe or unresponsive cases

Which appointment to book

If you have heel pain that sounds like a heel spur, you are recommended to book one of the following appointments:

A musculoskeletal (MSK) consultation
A biomechanical assessment, if a more extensive assessment, gait analysis and foot orthoses are required
Running video gait analysis, if you are predominantly a runner

If you are not sure which appointment is right for you, call us on 02920 644900 or email info@feetinfocus.com and we will help.

Common questions

Will I need surgery to remove a heel spur?

Very rarely. Most heel spur pain settles with conservative treatment such as stretching, footwear changes, heel cushioning and foot orthoses, because the pain usually comes from the inflamed tissue around the spur rather than the spur itself. Surgery is only considered in a small number of cases where pain continues after a long period of appropriate treatment, and we would refer you to an orthopaedic surgeon if that were needed.

Do I need an X-ray to find out if I have a heel spur?

Not usually. A heel spur can only be seen on an X-ray, but many people have a spur without any pain, and the treatment for heel pain is often the same whether a spur is present or not. Your podiatrists will examine your foot and decide whether an X-ray or scan would change your treatment. If it would, we can arrange a referral.

Will my heel spur go away?

The bony spur itself does not usually disappear, but that does not mean the pain will last. Once the strain on the heel is reduced and the surrounding tissue has settled, most people are pain free even though the spur is still there. Treating the underlying cause, such as tight calf muscles or the way your foot moves, also helps to stop the pain coming back.