Heel Spurs: Do They Really Cause Pain?
A heel spur is a small bony growth on the heel bone. They are common, often painless, and usually a sign of long-standing strain rather than the real cause of heel pain.
What a heel spur is
A heel spur (calcaneal spur) is a deposit of calcium that forms a bony projection on the underside or back of the heel bone, usually where the plantar fascia or Achilles tendon attaches. It builds up slowly over months in response to repeated tension on those tissues.
Do they cause pain?
This surprises many people: heel spurs are often not the source of pain. Plenty of people have spurs on X-ray with no symptoms at all, while others have severe heel pain and no spur. The spur is usually a marker of chronic strain rather than the thing pressing on a nerve.
What actually hurts
When a spur is found alongside heel pain, the real culprit is usually the soft tissue, most often plantar fasciitis or, at the back of the heel, Achilles or bursa problems. Treating that soft-tissue inflammation is what relieves the pain — not the spur itself.
Treatment
Because the spur is rarely the problem, treatment targets the underlying condition: calf and fascia stretching, supportive cushioned shoes, heel cups or orthotics, load management and anti-inflammatory measures. Most people improve without ever removing the spur. Surgery for a spur alone is uncommon.
When to see a professional
See a podiatrist if heel pain lasts more than a few weeks despite self-care, so the actual cause can be identified and treated. Do not assume a spur seen on an X-ray is what needs fixing.
Frequently asked questions
- Do heel spurs need to be removed?
- Rarely. Because the spur is usually not the source of pain, treating the underlying soft-tissue problem resolves symptoms for most people without surgery.
- Can you feel a heel spur?
- Not usually as a distinct lump from the outside. Pain attributed to a spur almost always comes from the surrounding plantar fascia or tendon, not the bone itself.
- What is the difference between a heel spur and plantar fasciitis?
- Plantar fasciitis is inflammation of the tissue along the sole; a heel spur is a bony growth that can form where that tissue attaches. The fasciitis is what hurts; the spur is a by-product.
Sources & further reading
- Heel spurs and plantar fasciitis, www.mayoclinic.org
- Heel pain, www.nhs.uk
- Calcaneal spur, www.apma.org