What is it?
Spurs form where tendons or ligaments pull on the heel bone over time. A spur on the bottom of the heel is associated with the plantar fascia. A spur on the back of the heel forms where the Achilles tendon attaches and is often linked to insertional Achilles tendinopathy.
What causes it?
- Long-term strain on the plantar fascia or Achilles tendon
- Tight calf muscles
- Foot mechanics such as flat feet or high arches
- Age-related changes
What does it feel like?
- Pain at the bottom or back of the heel
- Pain worst with the first steps of the day or after rest
- A tender bump at the back of the heel that rubs in shoes
How is it diagnosed?
X-rays show the spur. The exam determines whether the pain is actually coming from the spur area, the plantar fascia, the Achilles tendon, or something else, such as a nerve or stress fracture.
When should you see a podiatrist?
- Heel pain lasting more than two to three weeks
- A painful, enlarging bump on the back of the heel
- Heel pain that limits walking
Nonsurgical treatment
- Stretching
- Calf and fascia stretching reduces the pull on the heel.
- Heel cushioning and orthotics
- Offload the painful area.
- Shoe changes
- An open or soft heel counter for spurs at the back of the heel.
- Anti-inflammatory measures
- Ice and short courses of anti-inflammatory medication when appropriate.
- Injection or physical therapy
- For pain that does not settle with basic measures.
When is surgery considered?
Surgery is rarely needed for a spur on the bottom of the heel. A painful spur at the back of the heel with Achilles involvement is more likely to need surgery if months of conservative care have not helped.
For back-of-heel spurs, surgery typically removes the spur and any inflamed bursa and repairs or reattaches the Achilles tendon.
Related procedures
What is recovery like?
Recovery depends on the procedure. Achilles-related heel surgery usually involves a period in a boot or cast, then physical therapy, with a return to most activities over several months.
Frequently asked questions
Do heel spurs go away?
The bone itself does not usually disappear, but the pain associated with it often resolves with treatment of the surrounding soft tissue.
Should a heel spur be removed?
Only when it is clearly the source of persistent pain that has not responded to conservative care. Most spurs are left alone.