Heel Spur

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Introduction

What is a heel spur?

Your heel takes the brunt of your body’s weight with every step you take. Because of this, any issues with your heels could make walking difficult or even unbearable if pain is severe. One problem that can affect your heel is a heel spur. Heel spurs, or bone spurs (also called osteophytes), are small bulges or protrusions on your heel bone formed by calcium deposits. These deposits may build up if the ligament connected to your heel bone is constantly stretched and contracted, possibly causing small tears. Or, the ligament could tear away from the bone itself.

Heel spurs are common and it’s estimated about 1 in 10 adults has a heel spur. Many people never realize they have one because heel spurs don’t always cause pain or pain may only be intermittent. If you feel pain in your heel and your doctor suspects heel spurs but there are no obvious bumps, you may be diagnosed with heel spur syndrome.

Heel spurs are often associated with other foot conditions, such as plantar fasciitis, which is inflammation of the plantar fascia. This is a thick band of tissue that runs across the bottom of your foot, connecting your heel bone to your toes. About half of people with heel spurs have plantar fasciitis and some doctors use the term “heel spurs” instead of plantar fasciitis when speaking to their patients.

Symptoms

What are the symptoms of a heel spur?

Not everyone who has a spur on their heel experiences heel spur symptoms. Others experience pain when walking. The pain may be worse when you take the first few steps after getting up out of bed or after a period of prolonged sitting. There may also be a slight protrusion off the bottom of the heel. Many heel spurs are discovered by accident, while your foot is being examined for another reason.

Heel pain should not be ignored. See a doctor or podiatrist to evaluate your foot. Your doctor will investigate the possible cause and develop a treatment plan.

Causes

What causes a heel spur?

Heel spurs develop when calcium gradually builds up in one spot on the heel bone. This could be caused by strain on the foot and heel from repetitive or constant use, such as running or jumping, or the result of another foot condition. As the calcium builds up, it starts to form a bump, or the spur.

Risks

What are the risk factors for a heel spur?

Risk factors for heel spurs are mostly related to the pressure the heels are subjected to every day. They include:

  • Repeated running or jumping, particularly on hard surfaces like concrete

  • Short but frequent bursts of running or jumping

  • Occupations that require extended periods of standing or walking

  • Abnormal walking rhythm or gait that places extra pressure on the heel

  • Abnormal foot structure, such as a high arch or flat feet

  • Shoes that don’t support your feet adequately and put extra pressure on the heel

  • Being overweight or obese

  • Increasing age, as heel spurs are more common in older individuals

 People with diabetes are also at risk for developing heel spurs in addition to other foot conditions.

You may be able to reduce your risk of developing heel spurs

To reduce your risk:

  • Maintain a healthy body weight

  • Use proper technique when participating in sports that put increased pressure on your feet and heels

  • Warm up and stretch before starting a physical activity

  • Wear well-fitting supportive shoes, particularly for specific activities, such as running shoes for running

  • Wear shoe inserts (orthotics) to help manage abnormally high or low arches in your feet

  • If you have diabetes, follow your treatment plan to reduce the risk of complications

  • Consult with your doctor about foot pain in general and follow recommendations to treat it.

If you believe you are at risk for heel spurs, particularly if you already are having issues with foot and heel pain, speak with your doctor about your risk, to see if there are other steps you can take to help keep your feet healthy and strong.

Treatments

How is a heel spur treated?

Heel spurs that don’t cause pain or discomfort are usually not treated, but if they are painful your doctor may recommend heel spur treatment. The strategies are similar to treatment for plantar fasciitis:

  • Change your shoes to a pair that provides proper cushioning for your heel and support for your arches.

  • Stretch your feet, which can be as simple as walking barefoot a few times a day

  • Splint your foot at night or while you sleep

  • Take over-the-counter pain relievers, such as ibuprofen or acetaminophen

Heel spur surgery may be an option if the spurs are causing pain that limits your ability to function. In this case, under a local anesthetic, your orthopedic surgeon would make an incision in your foot and either remove the spur or release the plantar fascia, which may be the underlying cause of pain.

Complications

What are the potential complications of heel spurs?

Painful heel spurs may affect your ability to walk properly, which could change your gait and trigger problems with your knees, hips or back. Increased pain could also affect your quality of life, since you may avoid certain activities and regular exercise because of the pain it may cause.

If foot surgery is necessary to treat your heel spurs, consider the possibility of surgical complications. They include increased pain, infection, blood clots, and bleeding. It’s important to consult with an experienced foot surgeon to discuss the benefits and risks of heel surgery for your condition.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2017 Nov 13
  1. Bone Spurs. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/bone-spurs/expert-answers/heel-spurs/faq-20057821
  2. Plantar Fasciitis and Bone Spurs. American Academy of Orthopaedic Surgeons.  http://orthoinfo.aaos.org/topic.cfm?topic=a00149
  3. Heel Pain. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=a00159
  4. Plantar Fasciitis. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/plantar-fasciitis/symptoms-causes/syc-20354846
  5. Heel Injuries. Cleveland Clinic. https://my.clevelandclinic.org/health/articles/heel-pain
  6. Yakel J. A Guide to Conservative Care for Plantar Heel Pain. Volume 26 - Issue 11 - November 2013; pages 52 – 60. https://www.podiatrytoday.com/guide-conservative-care-plantar-heel-pain
  7. Heel Pain. American Medical Podiatric Association. http://www.apma.org/learn/FootHealth.cfm?ItemNumber=985
  8. Bone Spur. Michigan Medicine; University of Michigan. http://www.uofmhealth.org/health-library/tp23002spec
  9. Campitelli NA. Emphasizing Physical Therapy Exercises for the Feet. Podiatry Today. https://www.podiatrytoday.com/blogged/emphasizing-physical-therapy-exercises-feet
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