Heel spurs: What you need to know
Heels spurs may happen independently or may be related to an underlying health condition. People often assume that heels spurs are the cause of any pain in the heel, but other factors can also cause heel pain.
This article explores the symptoms of heel spurs, as well as other causes of heel pain. It also discusses the causes, risk factors, and treatments for the condition.
What is a heel spur?
Symptoms of heel spurs may include heat radiating from the affected area, a dull ache in the heel, and a sharp pain in the heel when standing.
A heel spur is a bony outgrowth that can occur on the underside of a person's foot. They are also known as calcaneal spurs or osteophytes.
Heel spurs may be pointy, hooked, or shelf-like. The outgrowth of a heel spur extends from the underneath of the heel towards the arch (the middle of the foot). This area of the foot is called the plantar fascia.
When seen on an X-ray, a heel spur may be up to half an inch long. If an X-ray is unable to confirm a suspected heel spur, a doctor may refer to the condition as "heel spur syndrome."
Symptoms of heel spurs can include:
- sharp pain like a knife in the heel when standing up in the morning
- a dull ache in the heel throughout the rest of the day
- inflammation and swelling at the front of the heel
- heat radiating from the affected area
- small, visible bone-like protrusion under the heel
- point of tenderness at the bottom of the heel that makes it hard to walk barefoot
If a person experiences these symptoms, a doctor may take an X-ray of their foot to determine the problem. Seeing the protrusion on an X-ray is the only way to be sure a person has heel spurs.
Not everyone with a heel spur will experience all of these symptoms. Some people with heel spurs may experience no symptoms at all. These people may only discover they have heel spurs if they have an X-ray for another reason.
Heel spurs happen when long-term muscle and ligament strain wears out the soft tissues in the heel. Tearing the membrane that covers the heel bone is also a cause.
The heel can also become more vulnerable with age. A 2015 review of heel pain noted that as a person ages, the pads in the heel wear down and fail to provide shock absorption.
Over time, calcium deposits can build up under the heel. These deposits form bony protrusions, which are heel spurs.
Risk factors for heel spurs may include athletic activities such as running and jumping.
There is a range of things that increase the risk of developing heel spurs. These include:
- Athletic activities: Running and jumping can wear down the heel and arch of the foot.
- Activity on hard surfaces: Frequently walking, running, or jumping on hard surfaces can wear down the heel.
- Trauma to the heel: Bruising the heel and tearing the membrane that covers it can lead to heel spurs.
- Getting older: A 2008 study found heel spurs to be common in older men and women.
- Being female: A 2014 study found that heel spurs are more common in women than men.
- Being overweight: Researchers also found that heel spurs were related to obesity.
- Improper footwear: Frequently wearing shoes that do not fit properly, have lost their support, or are not supportive, such as flip-flops, can lead to heel spurs.
There are also some underlying medical conditions that may cause heel spurs. These include:
- reactive arthritis (Reiter's disease)
- ankylosing spondylitis
- diffuse idiopathic skeletal hyperostosis
- plantar fasciitis
Heel spurs vs. plantar fasciitis
Heel spurs are often confused with a condition called plantar fasciitis. Having plantar fasciitis increases a person's risk of developing heel spurs. Heel spurs often occur in people who already have plantar fasciitis.
Up to 15 percent of people with foot symptoms that require medical attention have plantar fasciitis.
There are important distinctions between heels spurs and plantar fasciitis. A heel spur is a calcium deposit that forms a bony protrusion along the plantar fascia.
In contrast, plantar fasciitis is a condition where the plantar fascia gets irritated and swollen, which causes pain in the heel.
Doctors often describe the plantar fascia as a bowstring-like tissue. It stretches underneath the sole and attaches to the heel. Plantar fasciitis results from an unusual amount of force on this part of the foot.
Possible causes of significant force include:
- being obese
- walking or otherwise exercising the foot for a very long time
- wearing shoes that do not support the arch of the foot
Having diabetes is also a risk factor for plantar fasciitis.
Plantar fasciitis usually goes away without treatment. Heel spurs, on the other hand, are permanent unless medically treated.
Resting the feet may help to reduce the swelling and pain of heel spurs.
Treatments for heel spurs may include:
- Rest: Getting plenty of rest and taking pressure off the feet can help to reduce pain and swelling in the affected area.
- Applying ice: This can help reduce pain and swelling.
- Using custom-made orthotics (shoe inserts): These donut-shaped inserts go inside the shoe to take the pressure off the heel.
- Wearing cushioned sports shoes: These may also help to relieve pressure and reduce pain.
- Anti-inflammatory medication: This helps to reduce swelling.
- Cortisone injections: These reduce swelling and pain in the affected area. They are a stronger option if over-the-counter anti-inflammatory medication is not effective.
- In rare cases, surgery may be necessary to remove the heel spur. However, the above treatments are usually effective, and surgery is not needed.
If heel spurs are caused by an inflammatory type of arthritis, treatments for the underlying condition may also improve symptoms.
The outlook for heel spurs is positive. The calcium deposit will always be there unless surgically removed, but this is not normally problematic, as treatments to reduce pain and swelling tend to be effective.
In cases where treating the symptoms is not effective, surgery to remove the heel spur is possible.