Tennessee Foot & Ankle Clinic

Heel Spurs

What is a Heel Spur?

A heel spur is a calcium deposit causing a bony protrusion on the underside of the heel bone. On an X-ray, a heel spur can extend forward by as much as a half-inch. Without visible X-ray evidence, the condition is sometimes known as "heel spur syndrome."

Causes

Heel spurs occur when calcium deposits build up on the underside of the heel bone, a process that usually occurs over a period of many months. Heel spurs are often caused by strains on foot muscles and ligaments, stretching of the plantar fascia, and repeated tearing of the membrane that covers the heel bone. Heel spurs are especially common among athletes whose activities include large amounts of running and jumping.

X-ray image of calcaneus shows heel spur

Signs & Symptoms

Heel spurs often cause no symptoms. But heel spurs can be associated with intermittent or chronic pain -- especially while walking, jogging, or running -- if inflammation develops at the point of the spur formation. In general, the cause of the pain is not the heel spur itself but the soft-tissue injury associated with it.

Many people describe the pain of heel spurs and plantar fasciitis as a knife or pin sticking into the bottom of their feet when they first stand up in the morning -- a pain that later turns into a dull ache. They often complain that the sharp pain returns after they stand up after sitting for a prolonged period of time.

Nonsurgical Treatment

There is a variety of treatment options for heel spurs. The treatment your foot and ankle surgeon selects will depend on the severity of your heel spur and other factors.

A number of nonsurgical measures can be undertaken:

Stretching exercises. Your foot and ankle surgeon can provide or prescribe pads designed to shield corns from irritation. If you want to try over-the-counter pads, avoid the medicated types. Medicated pads are generally not recommended because they may contain a small amount of acid that can be harmful. Consult your surgeon about this option.
Changes in shoewear. Avoid shoes with high heels. Instead, choose comfortable shoes with heels no higher than two inches.
Orthotic devices. A custom orthotic device placed in your shoe may help control the muscle/tendon imbalance. Injection therapy. Corticosteroid injections are sometimes used to ease pain and inflammation caused by hammertoe.
Splinting/strapping. Splints or small straps may be applied by the surgeon to rest stressed muscles and tendons.

When is Surgery Needed?

More than 90 percent of people get better with nonsurgical treatments. If conservative treatment fails to treat symptoms of heel spurs after a period of 9 to 12 months, surgery may be necessary to relieve pain and restore mobility.