Texas Orthopedics

Heel Spurs

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Introduction

Heel spurs are abnormal bony growths that develop at the back of or under the heel.  Inflammation around a spur, more so than the spur itself, can cause significant pain.  Fortunately, symptoms can be eased with non-surgical treatments for the vast majority of people.
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Anatomy

Your heel bone is called the calcaneus.  It helps to bear and distribute your body weight across your foot when you stand or walk.  Soft tissues that help move and shape the foot are attached to the calcaneus.  One such tissue, the plantar fascia, forms the arch in the foot.
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Causes

Heel spurs develop in some people that have a condition called plantar fasciitis, inflammation of the plantar fascia.  Heel spurs form when the plantar fascia separates from the calcaneus.  An abnormal bone growth, a hook-like spur, forms from calcium deposits that grow at the site of inflammation. 

Heel spurs are more common in middle-aged adults and people that have had plantar fasciitis for a long time.  People with flat feet or high arches are vulnerable to heel spurs.  Women who wear high-heeled shoes are more susceptible, as well.
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Symptoms

Heel spurs may or may not cause symptoms.  Symptoms are usually related to the plantar fasciitis.  You may experience significant pain.  Your heel pain may be worse in the morning when you first wake up or during certain activities.
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Diagnosis

Your doctor will review your medical history and examine your foot.  X-rays are used to identify the location and size of the heel spur.
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Treatment

The majority of heel spurs are treated with non-surgical interventions.  These can relieve pain, but may take from about 3 months to up to a year for symptoms to resolve.  Rest, icing, and over-the-counter anti-inflammatory or prescription medications can help ease symptoms.  Cortisone injections may also be used.

You may be instructed to perform stretching exercises to help relax the tissues in the heel.  Your doctor may recommend custom orthotics or shoe inserts to position and cushion your heel. Night splints can help position the heel and arch of the foot while you sleep.

Some doctors may recommend extracorporeal shock wave therapy (ESWT).  This treatment uses energy pulses to start the repair process in the heel tissues.  ESWT is recommend when other non-surgical treatments have failed.
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Surgery

Surgery is used a very small percentage of the time.  It is usually considered after trying non-surgical treatments for at least a year.  Plantar fascia release surgery is use to relax the plantar fascia.  This surgery is commonly paired with tarsal tunnel release surgery.  Surgery is successful for the majority of people.
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Recovery

Recovery from non-surgical heel spur treatment can take considerable time, usually from three months to a year.  However, most doctors agree that non-surgical treatments should be tried for at least one year before considering surgery.
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Prevention

You can help prevent heel spur symptoms from returning by wearing the proper shoes.  Customized orthotics and insoles can help relieve pressure.  It is important to perform your exercises to help keep your foot stretched and relaxed.
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This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.

The iHealthSpot patient education library was written collaboratively by the iHealthSpot editorial team which includes Senior Medical Authors Dr. Mary Car-Blanchard, OTD/OTR/L and Valerie K. Clark, and the following editorial advisors: Steve Meadows, MD, Ernie F. Soto, DDS, Ronald J. Glatzer, MD, Jonathan Rosenberg, MD, Christopher M. Nolte, MD, David Applebaum, MD, Jonathan M. Tarrash, MD, and Paula Soto, RN/BSN. This content complies with the HONcode standard for trustworthy health information. The library commenced development on September 1, 2005 with the latest update/addition on February 16, 2022. For information on iHealthSpot’s other services including medical website design, visit www.iHealthSpot.com.

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