Heel spurs are bony growths that develop on the underside of the heel bone (calcaneus), where the plantar fascia attaches. They form gradually over time in response to long-term strain and traction at this attachment site, rather than as a result of a single injury. Heel spurs are often associated with plantar fasciitis, although they are not always the direct cause of pain.
Many people with heel spurs have no symptoms at all, and the spur is often an incidental finding on X-ray.
When symptoms do occur, they are usually related to irritation of the surrounding soft tissues rather than the spur itself. Contributing factors may include repetitive loading, tight calf muscles, poor foot biomechanics, prolonged standing, or inappropriate footwear.
Treatment for heel spurs is usually conservative and focuses on addressing the underlying soft tissue irritation rather than removing the bony spur itself. In most cases, symptoms improve without the need for surgery.
In cases where symptoms persist, additional treatments such as shockwave therapy or injection therapy (e.g. corticosteroid or regenerative options) may be considered to reduce pain and stimulate healing.
Surgery to remove heel spurs is rarely required and is only considered in persistent, refractory cases where conservative management has failed. Most patients experience significant improvement with a structured rehabilitation approach and can return to normal activity levels without long-term limitations.
Most cases of plantar fasciitis treatment is managed conservatively, with excellent results when treated early.
Non-surgical options include:
Stretching exercises, particularly for the plantar fascia and calf muscles
Ice therapy to reduce inflammation and pain
Orthotic insoles or heel cups to offload pressure from the heel
Supportive footwear with good arch support and cushioning
Night splints, which keep the foot in a stretched position overnight
Shockwave therapy, a non-invasive treatment that promotes healing in chronic cases
Corticosteroid injections may be used for short-term pain relief in more resistant cases, although repeated injections are avoided due to the risk of fascia weakening.
Surgical intervention is rarely needed, and most patients recover fully with appropriate non-invasive treatment and rehabilitation. If surgery is required this might involve partial release of the plantar fascia.
