Heel spur

A heel spur is a small bony growth that forms at the bottom of the heel, often where the plantar fascia attaches to the heel bone. Heel spurs can develop slowly from repeated stress on the heel, and many people don't know they have one until an X-ray shows it. When heel spurs cause pain, it can make everyday activities like walking, standing or exercising uncomfortable.

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Anatomy of the heel

Your heel bone, called the calcaneus, supports much of your body weight every time you stand or take a step. The plantar fascia, a band of tissue that runs along the bottom of your foot, connects to the heel bone and helps support your arch.

When the plantar fascia experiences repeated strain, the tissue can pull at the point where it attaches to the heel. Over time, this stress can lead to extra bone growth, forming a heel spur. Heel spurs often develop alongside plantar fasciitis, a common cause of heel pain, though the two conditions are not always present together.

Overview

Symptoms

Heel spurs don't always cause symptoms, but when they do, you may notice:

Sharp or stabbing pain in the bottom of the heel
Pain that improves after walking but returns with prolonged activity
Tenderness or swelling at the bottom or back of the heel
Discomfort in flat, unsupportive shoes or when walking barefoot on hard surfaces

Some people have a heel spur visible on X-ray without any pain, while others experience significant discomfort from the surrounding soft tissue. Without evaluation, symptoms can become long-lasting or begin to affect the way you walk.

Causes

Heel spurs develop when repeated stress at the bottom of the heel leads to extra bone growth where soft tissue attaches to the heel bone. Common contributing factors include:

Tight calf muscles
Flat feet or high arches
Poor shoe support

Over time, this repeated pressure and strain can cause a small bony growth that shows up on an X-ray.

Risk factors

Certain factors can make heel spurs more likely to develop, though having one or more of these does not mean you'll experience pain or symptoms:

Frequent walking, running or standing on hard surfaces
Being overweight, which adds extra stress to the heel
Wearing shoes with little arch support or cushioning
Having flat feet, high arches or an uneven walking pattern
Age-related changes in foot structure

Your foot and ankle specialist can help you understand which factors may be contributing to your symptoms.

Diagnosis

Your foot and ankle specialist will take time to understand your symptoms, daily activities, work routine and shoes, then examine your heel to see exactly where and when it causes pain. Diagnosis may include a careful exam of your foot and ankle, including checking specific areas of the heel and watching how you stand and walk.

X-rays can help identify a heel spur, examine the heel bone and rule out fractures or other causes of heel pain. Your specialist may also review other conditions, such as arthritis, diabetes or walking patterns, that could be contributing to your symptoms.

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