Some aches and pains take a long time to appear, but after spending many days on your feet or limping after exercise, there’s no way to ignore them: you have heel pain that won’t go away.
Heel pain is often related to conditions like stress fractures, plantar fasciitis, or Achilles tendonitis. But if you’re trying to figure out why your heel hurts, it’s also important to understand other possible causes, like heel spurs.
Heel spurs, also known as heel spurs, are small bony bumps that usually form as a result of plantar fasciitis or Achilles tendonitis, although they can also form on their own. It’s important to note that heel spurs are usually not painful, with only 5% of cases causing symptoms. Read on to learn why heel spurs form, the symptoms they can cause, and what treatment options you’ll have if you’re diagnosed with one.
Heel spurs are caused by an inflammatory response.
Heel spurs are the result of the body’s healing process. When a tendon or ligament is damaged, it becomes inflamed as the body attempts to repair it. If a particular tendon or ligament is frequently inflamed over a long period of time, the body may respond by gradually growing additional bone near it.
Because of this relationship between bone growth and inflammation, heel spurs often form as a result of conditions that involve inflammation, such as plantar fasciitis, Achilles tendonitis, and osteoarthritis. However, heel spurs can result from anything that puts significant stress on the feet over time, whether in the form of pressure, rubbing, or strain. Some examples include:
- A way of walking that distributes weight unevenly
- High impact activities such as dancing or running.
- Regularly wearing shoes that do not provide arch support, are too tight, do not fit properly, or distribute weight unevenly (such as high heels)
- Being overweight
- Natural loss of cartilage, the substance that cushions joints, as a result of aging.
Types of heel spurs
There are two types of heel spurs, named according to where they form on the heel:
- Plantar heel spurs They occur on the bottom of the heel. They usually form as a result of plantar fasciitis, which is inflammation of the connective tissue that runs from the heel to the ball of the foot.
- Posterior heel spurs They occur at the back of the heel. They usually form as a result of Achilles tendonitis, which involves stiffness and inflammation in the large tendon that runs from the heel to the ankle.
Heel spurs cause symptoms when they affect other parts of the feet.
Heel spurs are rarely the direct cause of heel pain. Even when a person has heel spurs and heel pain, it is more common for the pain to be caused by the condition that caused the heel spurs in the first place. However, heel spurs can cause symptoms if they press on nerves or tissues in the foot.
What do heel spurs feel like?
If you have a heel spur, you may feel a small bump on the bottom or back of your heel. You may also feel changes in the skin around it if you regularly press or rub against your shoes. This may take the form of a callus (a small area of thickened, tender skin) or a corn (a patch of thickened skin).
Heel pain related to a heel spur is often similar to the pain caused by plantar fasciitis: It may be more intense after long periods of rest, lessen during activity, and then worsen again after standing or being active for a long period. The pain itself may feel sharp, dull, or throbbing, and there may be tenderness or swelling around the spur. If the heel spur is pressing on nerves in your foot, you may also feel a tingling or burning sensation when you put pressure on it.
What do heel spurs look like?
If the heel spur is large enough, you may be able to see the small bump on your heel. Otherwise, heel spurs are only visible on imaging tests, such as X-rays or CT scans. When looking at a side view of your foot during an imaging test, a heel spur may look like a small, smooth or hook-shaped growth on your heel bone.
Heel spurs are usually diagnosed during imaging tests.
Since there are a variety of health conditions and factors that can cause heel pain, doctors usually don’t look for heel spurs first. To rule out other possible causes, your doctor will first talk to you about your medical history and perform a physical exam. Then, if he or she thinks your pain may be related to a stress fracture or structural problem in your foot, he or she will perform an imaging test. This is where a heel spur will show up, and it’s how most heel spurs are diagnosed.
If you have heel pain and have been diagnosed with heel spurs, treatment focuses on managing symptoms and treating any underlying conditions. This may include:
- Over-the-counter anti-inflammatory medications such as ibuprofen, naproxen, or a short course of oral steroids.
- Supporting your feet With rigid, supportive footwear and orthotic devices such as braces, arch supports, or heel cups. Orthotics can be purchased over the counter or custom-made for your feet with a prescription.
- Stretch and strengthen your feet On your own or with the help of a physical therapist, stretching your calf muscle will be the most effective way to reduce heel pain. Other examples of stretching exercises include rolling a tennis ball under your feet or leaning against a wall with your feet staggered behind you to feel a stretch in the Achilles tendon of your back foot.
- Corticosteroid injections for longer lasting relief from pain and inflammation if other treatments are not effective.
Some treatments depend on the cause of your heel spurs. For example, if they are related to the way you walk, a physical therapist can help you retrain your walking to be more balanced. Similarly, a physical therapist can tailor a stretching and strengthening program to focus on the tendons on the bottom or back of your foot if you have plantar fasciitis or Achilles tendonitis.
Heel spurs do not go away on their own. In rare cases where other treatments are not effective or the heel spurs damage the tissues around them, they may be removed surgically. If there is an underlying cause that can be treated surgically, another procedure may be performed at the same time, such as joint repair for osteoarthritis or plantar fascia release.
If you think you may have a heel spur, talk to a podiatrist.
It can be difficult to determine if you have a heel spur, and if you have heel pain, heel spurs may not be the only reason. But any time you have heel pain that won’t go away, it’s important to see a doctor. You deserve to be comfortable on your feet, and a podiatrist can help. Once you have a diagnosis and treatment recommendations from an expert, you can start getting back to moving the way you want.
