The doctor states that the x-ray shows that there is a heel spur.  What is a heel spur? What causes it to form? Why does it hurt?

A heel spur is a hook-shaped piece of bone coming off the calcaneus. The calcaneus is the bone that makes up the heel.  This hook-shaped spur forms because the support of the arch, which is called the plantar fascia, is being pulled too tightly and may be inflamed. The spur starts to form on the calcaneus where the plantar fascia attaches. Many times people think it is this spur, which is causing the pain, but in actuality the pain is coming from the plantar fascia being strained.

Plantar fasciitis is a condition in which the presence of heel spurs is extremely common. Symptoms of plantar fasciitis are:

  • Heel pain when first waking up in the morning, but then lessening after walking for awhile
  • Heel pain with climbing stairs or standing for long periods of time
  • Heel pain after exercise
  • Usually only one heel will hurt

Heel pain is one of the most common patient complaints in the field of podiatry.  This heel pain that is usually diagnosed as plantar fasciitis is more prevalent in men and women that are 40-60 years old. Plantar fasciitis is caused for many reasons, which include:

  • Obesity
  • A sudden weight gain
  • Running sports
  • Consistently running or walking on uneven surfaces
  • Shoes with little to no arch support
  • Differing length of the legs

Since this is a very common problem, there are numerous ways that the heel pain can be relieved. Some of these include:

  • More supportive shoes
  • Adding a small heel lift or heel cup to the shoes
  • Decreasing exercise temporarily
  • Custom-made orthoses
  • Stopping the foot from moving for 3-6 weeks using a boot cast
  • Exercises that specifically stretch the plantar fascia
  • Icing the area of pain for about 10 minutes two times per day
  • Tylenol or ibuprofen
  • Wearing a night splint while sleeping
  • A steroid injection given by the podiatrist into the heel

These treatment options may take months or maybe even a year to get rid of or lessen the heel pain. The average patient usually takes about nine months of these treatments to notice less or no heel pain, so persistence is important. However, sometimes, in rare cases, these treatment plans may not work. If that is the case, a surgical procedure can be done to lengthen the plantar fascia in order to remove the tension on the plantar fascia, which is causing the pain.

Even though, on the x-ray, the heel spur may appear large and sharp, it is not what is causing the pain. The heel spur is just an indication that the plantar fascia making up the arch has too much tension.


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