What is a heel spur?
A heel spur is a bony protrusion that can form on the bottom of a person’s foot. They are also known as calcaneal spurs or osteophytes.
Heel spurs can be pointed, hooked, or shelf-like. The protrusion of a heel spur extends from the bottom of the heel to the arch (middle of the foot). This area of the foot is called the plantar fascia.
Symptoms of a heel spur include pain that can be sharp or dull. A person may also feel heat radiating from the affected area.
When seen on an X-ray, a heel spur can be up to half an inch long. If an X-ray cannot confirm a suspected heel spur, your doctor may refer to the condition as “heel spur syndrome.”
Heel spurs can occur independently or may be related to an underlying health condition. People often assume that a heel spur is the cause of any pain in the heel, but other factors can also cause heel pain.
What are the symptoms of heel spurs?
The following symptoms may indicate a heel spur:
- A sharp stabbing pain in your heel when you wake up in the morning
- A dull ache in your heel for the rest of the day
- Inflammation and swelling at the front of the heel
- Heat radiating from the affected area
- A small, visible bone-like protrusion under the heel
- A tender spot on the underside of the heel that makes it difficult to walk barefoot
When you experience these symptoms, seeing the protrusion on an X-ray is the only way to be sure that you have a heel spur.
Not everyone with a heel spur will experience all or none of these symptoms. An X-ray may be done for another reason to detect a heel spur.
What causes heel spurs?
Heel spurs occur when long-term muscle and ligament strain wears down the soft tissues in the heel. Tearing of the membrane that covers the heel bone is also a cause.
The heel can become more vulnerable with age. A 2015 review of heel pain noted that as people age, the pads in the heel wear down and fail to provide shock absorption.
Over time, calcium deposits can form under the heel. These deposits form bony protrusions that form heel spurs.
What increases the risk of developing heel spurs?
Risk factors for heel spurs include:
- Athletic activities: Running and jumping can wear down the heel and arch.
- Activity on hard surfaces: Frequent walking, running or jumping on hard surfaces can wear down the heel.
- Heel trauma: Bruising of the heel and tearing of the membrane that covers it can lead to a heel spur.
- Aging: A 2008 study found that heel spurs are common in older men and women.
- Being a woman: A 2014 study found that heel spurs are more common in women than in men.
- Being overweight: Researchers say heel spurs are associated with obesity.
- Improper shoes: Frequently wearing shoes that do not fit properly, are unsupportive, or are unsupportive, such as slippers, can lead to heel spurs.
- There are also some underlying medical conditions that can cause heel spurs:
- Reactive Arthritis (Reiter’s Disease): A type of inflammatory arthritis that develops in response to an infection elsewhere in the body and often affects the joints, eyes, and urinary tract.
- Ankylosing Spondylitis: An inflammatory disease that can cause the vertebrae to fuse over time. This fusion makes the spine less flexible and can cause a stooped posture.
- Common Idiopathic Skeletal Hyperostosis: It can cause bony growths and hardening around your spine, hips, knees, shoulders, feet and hands.
- Plantar Fasciitis: Inflammation of the fibrous tissue (plantar fascia) on the bottom of your foot that connects your heel bone to your toes.
What is the difference between heel spurs and plantar fasciitis?
Heel spurs are often confused with a condition called plantar fasciitis. However, there are important differences between the two. A heel spur is a calcium deposit that forms a bony protrusion along the plantar fascia. In contrast, plantar fasciitis is a condition in which the plantar fascia becomes irritated and swollen, causing pain in the heel.
Having plantar fasciitis increases a person’s risk of developing a heel spur. Up to 15% of people who have symptoms that require medical attention have plantar fasciitis.
If you are overweight, walk or exercise for long periods of time, wear shoes that do not support the arch of your foot, or have diabetes, your risk of developing plantar fasciitis increases. These conditions can put intense pressure on the plantar fascia, which can lead to inflammation and pain. If your body mass index (BMI) is 30 or higher, your risk of developing plantar fasciitis is almost six times higher than that of a normal-weight person.
Plantar fasciitis usually goes away without treatment. On the other hand, heel spurs are permanent if not treated medically.
Treatments for heel spurs are generally as follows:
Rest: Getting plenty of rest and reducing pressure on the feet can help reduce pain and swelling in the affected area.
Applying ice: Can reduce pain and swelling.
ESWT treatment: This is a preferred option when other treatment methods fail. In this method, sound waves are applied to the heel spur in the form of a shock. In this process, also known as “heel spur fracture” among the public, the calcium deposit under the heel is broken up with energy waves.
Using custom-made orthotics (shoe insoles): These ring-shaped insoles are placed inside the shoe to relieve pressure on the heel.
Wearing cushioned athletic shoes: Can help relieve pressure and reduce pain.
Anti-inflammatory medications: Reduce swelling.
Cortisone injections: Reduce swelling and pain in the affected area. If anti-inflammatory medications are not effective, they can be used as a stronger option.
Surgery: Heel spurs can usually be treated without surgery. However, surgery is an option when other treatments have failed. During surgery, the inflammation in and around the heel can also be removed. The healing process can take 6 to 8 weeks and physical therapy may be required after the stitches are removed. Some patients may need to use bandages and crutches during their recovery.
If heel spurs are caused by an inflammatory type of arthritis, treatments that target the underlying condition can also improve symptoms.