Heel Spurs: What They Are and What you can do about them
Heel spurs are common bony growths on the heel bone. They don’t always cause pain, but can lead to heel discomfort, especially when combined with soft tissue stress (i.e. plantar fascia).
In this blog, we explain what heel spurs are, why they develop, how to tell if they’re a problem and what you can do to treat or prevent them in the future.
TL;DR: Heel Spurs | The key takeaways
- Heel spurs = small bony growth on the heel bone, often from calcium build up around ligaments/tendons
- Many people with heel spurs are pain-free
- Pain is usually caused by irritated and inflamed soft tissues, not the bone spur itself
- Diagnosis can be made through a foot/structural physio assessment and x-ray
- Conservative treatment is best for heel spurs: supportive shoes, orthotics (if required), stretching, strengthening of the intrinsic foot muscles, load management, shockwave therapy dry needling and joint mobilisation therapy
- Surgery is rare and may only be recommended only if the pain is severe and unresponsive to conservative management
- Prevention is achieve by managing stress/load in the feet i.e. appropriate footwear, healthy bodyweight, foot care and addressing foot biomechanics
- Cortisone injections for heel pain is not recommended as the first line treatment
What is a heel spur?
A heel spur (also called a “calcaneal spur” or “bone spur”) is a small bony projection that forms on the heel bone (calcaneus). It usually appears on the underside (plantar fascia origin) or back of the heel (Achilles tendon insertion) where the tendons or ligaments attach to the bone.
The spur develops gradually over time because calcium deposits accumulate at the attachment site of these soft tissues.
Why do heel spurs develop?
Heel spurs often arise in response to repeated stress or tension on the foot’s soft tissues.
Most commonly, the ligament on the sole of the foot called the plantar fascia is affected.
Common contributing factors include:
- Repetitive or prolonged standing, walking, running or jumping, especially on hard surfaces
- Wearing unsupportive or worn-out shoes that lack arch support or cushioning
- Foot structure and biomechanical issues (e.g. flat feet, overpronation, muscle imbalances, tight calves)
- Aging (as the heel’s fat pad thins and flexibility reduces) or weight gain which increases load on the heel
A bony spur forms over time, as the body lays down extra calcium at the stressed site to strengthen and reinforce the area.
Do heel spurs always cause pain?
Not at all. Many people with heel spurs never notice them and are usually found on x-ray when the foot is imaged for another reason.
When you experience heel pain, the pain usually comes from the irritation and inflammation of the surrounding soft tissues (like the plantar fascia), not from the bone spur “piercing” tissue like some people might think.
Typical symptoms can include:
- A sharp or stabbing pain in the heel, often worse with the first steps in the morning or after rest
- Dull aching or throbbing pain during the day, especially after prolonged standing or activity
- Tenderness or sensitivity under the heel or at the back of the heel
- Discomfort when walking barefoot or in shoes without good support
- Sometimes swelling, warmth or a sense of pressure in the heel
How is a heel spur diagnosed?
If you suspect a heel spur, a clinician (physiotherapist or podiatrist) will likely take a full history and perform a physical exam.
This can include palpating the heel, assessing foot posture, joint flexibility (e.g. big toe extension), gait and soft tissue tenderness.
An x-ray is typically used to confirm the presence of the bony spur however it really a necessity.
Because many heel spurs exist without causing pain, assessing the soft tissue (like the plantar fascia) helps determine whether the spur is actually responsible for symptoms.
treatment & management for heel spurs
Because the spur itself is a bone growth and isn’t the cause of pain, treatment is rarely directed at removing the spur itself.
Instead, the focus is on reducing the stress and inflammation on the soft tissues that is causing the symptoms.
Common conservative treatments
- Resting the foot and temporarily reducing high-impact activities like running
- Apply ice or heat to assist with pain management
- Wearing supportive footwear or using custom-made orthotics to cushion the heel and encourage a neutral foot posture
- Stretching and strengthening exercises for the plantar fascia, calf muscles, intrinsic foot muscles, ankle and further up the kinetic chain (i.e. glutes)
- Physiotherapy techniques which may include soft tissue massage, joint mobilisation therapy, low die taping, exercise, dry needling and shockwave therapy
- Anti-inflammatory medication (e.g. NSAIDs) for short-term pain relief, where appropriate
For most people, symptoms improve with structured physiotherapy and conservative management
When is surgery considered?
Surgery to remove a heel spur is rarely needed. It’s only considered when pain persists and conservative treatments have failed over a very long period of time.
Even if a spur is removed, they can grow back again if the underlying biomechanics and strain/overload in the foot isn’t addressed.
How to reduce your risk of developing a heel spur?
Since heel spurs often stem from repeated/chronic stress and poor foot mechanics, prevention revolves around reducing those risks.
Helpful strategies include:
- Wear shoes appropriate for your foot type (neutral, supportive) and well cushioned, especially for work, walking and exercises such as running
- Avoid prolonged standing or walking on hard surfaces
- Include regular stretching and strengthening of the calf muscles, tibialis posterior, plantar fascia and foot stabilisers
- If you have flat feet, overpronation or other foot posture issues, make sure to consult a physiotherapist or podiatrist to address these issues
- Maintain a healthy weight to reduce load on your feet and heels
- Gradually build up intensity if you are starting a new sport or increasing training load
FAQs
Can heel spurs go away on their own?
The bone spur itself doesn’t disappear, but the pain often does. Once inflammation and tissue overload settle with conservative management (like physio, supportive footwear and exercises), most people return to normal activity without symptoms.
Can I keep walking or running with a heel spur?
Yes, as long as the pain is manageable and improving. You may need to adjust your training load, switch to softer surfaces or improve footwear. If pain is sharp, getting worse or changing with your walking, it’s best to get it checked.
When should I see a physio for heel spurs?
If heel pain lasts more than a couple of weeks, is sharp in the morning or stops you walking comfortably, it’s worth seeing a physiotherapist. Early treatment helps settle the irritation, improves foot mechanics and reduces the chance of developing chronic heel pain.
How long does it take for a heel spur to recover?
Recovery varies, but most people start feeling better within 4-6 weeks with the appropriate management.
Full recovery (i.e. you can walk, work and exercise without flare up) often takes 6-12 weeks.
Can a cortisone injection fix my heel spur?
A cortisone injection may help reduce heel pain in the short term, however cortisone does not fix the underlying cause.
Cortisone injections have been shown to weaken the soft tissues (increasing risk of tears) and can increase the risk of developing arthritis and therefore, is not recommended in the first instance.
Ready to fix your heel pain for good?
If you heel pain has been slowing you down, don’t wait for it to “settle on its own”.
Heel pain is much easier to treat when you get the right management early.
References
Koc, T.A., Martin, R.L., Davenport, T.E., et al. 2023, Heel Pain—Plantar Fasciitis: Revision 2023. Clinical Practice Guideline, Orthopaedic Section of the American Physical Therapy Association, viewed <5th December 2025>, https://www.orthopt.org/uploads/content_files/files/Heel_Pain_Plantar_Fasciitis_Revision_2023.pdf
