Heel pain is frustrating and can be long-standing and difficult to treat without the right diagnosis and therapies available. As a lot of confusion exists around heel spurs and heel pain, we thought we’d answer the top misconceptions and questions we get around heel spurs:

• What are heel spurs?
• What causes heel spurs?
• Are heel spurs the cause of heel pain?
• Are heel spurs and plantar fasciitis heel pain the same thing?

What is a heel spur & how is it caused?

A heel spur is a type of bony spur (outgrowth), or hard calcified area, that can develop on the bottom of the heel. Medically speaking, it’s called an osteophyte. It can look like a small spike or hook which faces the inside of the arch, following the same path as a soft tissue on the bottom of the heel called the plantar fascia. 

Heel spurs develop in response to damage and strain to the soft tissues that insert at the bottom of the heel. Gradually, over many months, calcium deposits build up to form the spur. While the cause of heel spurs and plantar fasciitis heel pain have definite cross-overs, like excess pressure on the heel bone, abnormal foot biomechanics, worn-out or unsupportive footwear and increased exercise on hard surfaces, the two conditions are very different.

Heel spurs may also be caused by inflammatory arthritis, and may be encouraged by other problems like the breakdown of the fat pad of the heel.

Are heel spurs and plantar fasciitis heel pain the same thing?

No. While the terms plantar fasciitis and heel spurs are often used interchangeably, this is technically inaccurate, as, by definition, plantar fasciitis is the inflammation of the plantar fascia tissue. The plantar fascia is a thick ligamentous band that runs from the bottom of the heel to fan out across your arch and insert into your toes. When the plantar fascia is damaged and inflamed, this is plantar fasciitis. We’ve shared all about the causes, symptoms and treatment of plantar fasciitis heel pain here.

Are heel spurs the cause of heel pain?

Sometimes, but nowhere near as often as plantar fasciitis is the cause of heel pain. You do not have to have a heel spur to have heel pain, and if you do have a heel spur, it does not mean that you will experience any heel pain. Interestingly, it’s estimated that 10% of the population have a heel spur, whether they are aware of it or not. We see many radiographs of patients that don’t have heel pain but do have a heel spur, or that do have heel pain but do not have a heel spur.

When heel spurs do cause painful symptoms, they can often be effectively managed using a combination of supportive footwear, custom foot orthotics, and managing any resulting swelling. In less common cases, when conservative treatment is not effective in managing heel spurs, surgery may be indicated to remove the spur.

FAQ’s

I have an x-ray showing that I have a heel spur. What should I do?

This depends. Is your heel spur causing any pain or problems? If you are getting pain on the foot with the identified spur, is it really the spur that is producing symptoms or is it something else like plantar fasciitis? All of these are really important questions to answer before knowing the best thing to do about your heel spur. We’ll go through all of this during your consultation.

How can I tell if I have a heel spur?

The only way to definitely know if you have a spur at the bottom of your heel is through an x-ray. With this said, an x-ray does not tell you if your spur is causing any pain, or whether the same mechanism of action that caused the spur is also causing your heel pain.

Can spurs be surgically removed?

Yes, orthopaedic surgeons can remove heel spurs. It should be noted that for most people, the spur is not the cause of their heel pain, so it’s important to have the connection between the two confirmed before pursuing invasive surgery.