Orthopedics Leg, Foot & Ankle An Overview of Heel Spurs By Jonathan Cluett, MD Jonathan Cluett, MD LinkedIn Twitter Jonathan Cluett, MD, is a board-certified orthopedic surgeon with subspecialty training in sports medicine and arthroscopic surgery. Learn about our editorial process Updated on April 16, 2023 Medically reviewed by Yaw Boachie-Adjei, MD Medically reviewed by Yaw Boachie-Adjei, MD LinkedIn Yaw Boachie-Adjei, MD, is a board-certified, double-fellowship Orthopedic Surgeon. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Symptoms Causes Diagnosis Treatment Frequently Asked Questions A heel spur (also known as a calcaneal spur) is a bony outgrowth that you can sometimes see and feel on the underside of your foot. It is made up of calcium deposits and can have a pointy, hooked, or shelf-like shape. There are several causes of heel spurs, but they very often occur in patients with plantar fasciitis, or the inflammation of the plantar fascia—the tissue that runs along the bottom of the foot and connects the heel to the toes. Marco Vacca / Getty Images Many people think that heel spurs cause heel pain—but that’s not always the case. According to the Cleveland Clinic, one out of 10 people have heel spurs, but only one out of 20 people with a heel spur experiences heel pain. Others may experience symptoms that include tenderness, a dull ache, or sharp pain when standing. What Is Plantar Fasciitis? Symptoms Most often, it's not the heel spur that causes the pain, but the inflammation and irritation of the plantar fascia. Heel pain is worst in the morning after sleep (some people say it feels like a knife going into the heel), making it difficult to take those first steps out of bed. This is because the foot is resting in plantar flexion overnight (i.e., your toes are pointed down), which causes the fascia to tighten. As you put pressure on the foot, the fascia stretches, which causes pain. This does subside as you begin to move and loosen the fascia (although you will likely still feel a dull ache), only to return after walking or standing for extended periods. Other symptoms of heel spurs include: A small, visible protrusion: On X-rays, a heel spur can be up to a half-inch long. Inflammation and swelling Burning, hot sensation Tenderness that makes it painful to walk barefoot Causes Heel spurs occur in 70 percent of patients with plantar fasciitis. The plantar fascia is one of the major transmitters of weight across the foot as you walk or run. When the plantar fascia becomes inflamed, a heel spur can form at the point between the fascia (the tissue that forms the arch of the foot) and the heel bone. Most common among women, heel spurs can also be related to another underlying condition, including osteoarthritis, reactive arthritis (Reiter’s disease), and ankylosing spondylitis. Other causes of heel spurs include: Overuse: Activities like running and jumping, especially if done on hard surfaces, can cause heel spurs by wearing down the heel and arch of the foot.Obesity: The more weight you carry around, the greater your risk of heel spurs. Improper footwear: Ill-fitting or non-supportive footwear (like flip-flops) can cause heel spurs. Diagnosis Your healthcare professional may ask about your history of heel pain and examine your foot for tenderness at the bottom of the foot, near the heel. She may ask you to flex your foot to assess pain and range of motion. She will also visually examine the heel looking for a protrusion, which may or may not be present. A heel spur diagnosis is formally made when an X-ray shows the bony protrusion from the bottom of the foot at the point where the plantar fascia is attached to the heel bone. Other Possible Causes of Heel Pain Treatment By and large, the treatment of heel spurs is the same as that of plantar fasciitis, with the first step being short-term rest and inflammation control. For the majority of people, heel spurs do get better with conservative treatment that may include: Rest Icing Anti-inflammatory medication Stretching Orthotics Physical therapy Stretching Exercises for Plantar Fasciitis The heel spur will not go away with these treatments, but the discomfort it causes can usually be sufficiently controlled with their use. When that's not the case, cortisone injections may be helpful in some individuals. Surgery to remove the heel spur is rare and only necessary when the trial of (and dedication to) the above treatments have failed. Frequently Asked Questions What are the symptoms of a heel spur? Heel spur symptoms can include heel pain that is worst in the morning when waking up, inflammation, swelling, a burning or hot sensation, tenderness, and a small, visible protrusion in the heel. If you have heel pain, it's a good idea to speak with a healthcare provider to find the cause. What causes a heel spur? A heel spur is a common occurrence in people with plantar fasciitis, a condition that causes sharp or dull pain at the bottom of the heel. Underlying conditions such as osteoarthritis, reactive arthritis, and ankylosing spondylitis can also cause a heel spur to form. Other causes include heel overuse, obesity, and ill-fitting footwear. How can I treat a heel spur? There are a few different methods to treat a heel spur. These include getting plenty of rest, pressing a covered ice pack against the area, using an anti-inflammatory medication, stretching, wearing orthotics (shoe inserts to decrease foot pain), and physical therapy. 6 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Ahmad J, Karim A, Daniel JN. Relationship and Classification of Plantar Heel Spurs in Patients With Plantar Fasciitis. Foot Ankle Int. 2016;37(9):994-1000. doi:10.1177/1071100716649925 Krukowska J, Wrona J, Sienkiewicz M, Czernicki J. A comparative analysis of analgesic efficacy of ultrasound and shock wave therapy in the treatment of patients with inflammation of the attachment of the plantar fascia in the course of calcaneal spurs. Arch Orthop Trauma Surg. 2016;136(9):1289-1296. doi:10.1007/s00402-016-2503-z Kirkpatrick J, Yassaie O, Mirjalili SA. The plantar calcaneal spur: a review of anatomy, histology, etiology and key associations. J Anat. 2017;230(6):743-751. doi:10.1111/joa.12607 Alatassi R, Alajlan A, Almalki T. Bizarre calcaneal spur: A case report. Int J Surg Case Rep. 2018;49:37-39. doi:10.1016/j.ijscr.2018.06.006 Boules M, Batayyah E, Froylich D, et al. Effect of Surgical Weight Loss on Plantar Fasciitis and Health-Care Use. J Am Podiatr Med Assoc. 2018;108(6):442-448. doi:10.7547/15-169 Agyekum EK, Ma K. Heel pain: A systematic review. Chin J Traumatol. 2015;18(3):164-9. doi:10.1016/j.cjtee.2015.03.002 Additional Reading American Academy of Orthopaedic Surgeons. "Plantar Fasciitis and Bone Spurs." https://orthoinfo.aaos.org/en/diseases--conditions/plantar-fasciitis-and-bone-spurs. Cleveland Clinic. “Think You Have a Heel Spur? It’s Probably Plantar Fasciitis.” https://health.clevelandclinic.org/think-heel-spur-probably-plantar-fasciitis. Johal KS, Milner SA. "Plantar Fasciitis and the Calcaneal Spur: Fact or Fiction?" Foot and Ankle Surgery. 2012;18(1):39-41. doi: 10.1016/j.fas.2011.03.003. By Jonathan Cluett, MD Jonathan Cluett, MD, is board-certified in orthopedic surgery. He served as assistant team physician to Chivas USA (Major League Soccer) and the United States men's and women's national soccer teams. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit