Worried you might have a heel spur? Otherwise known as an osteophyte, a heel spur is a bony outgrowth from the heel bone that looks like a small spike or hook that faces the inside of the arch. Heel spurs are made of calcium deposits that build gradually over many months or years. Alongside being present at the bottom of the heel, spurs can develop anywhere that tendons attach to bone – whether that be at the back of the heel bone at the Achilles tendon, or on other bones across the entire body.
In order to be diagnosed with a heel spur, you need to have a bony growth larger than 2mm protruding from your heel, regardless of whether you’re experiencing any pain. This is estimated to be present in around 15% of people.
What are the signs of a heel spur?
When a heel spur is symptomatic, it typically presents as moderate to high heel pain. Because the spurs can then aggravate the tissue they’re embedded in (which in the case of heel spurs is the plantar fascia tissue at the bottom of the heel), you then may also experience the symptoms of plantar fasciitis, which may culminate to include:
- Pain or tenderness in the heel of the affected foot which can feel sharp, dull or may throb
- Inflammation at the bottom of the heel, or the location where the spur is present
- Pain when walking or exercising without supportive shoes, or in bare feet
- The feeling of a small, bony bump on the bottom or back of your heel
- Numbness, burning and tingling if the nerves are impacted by the spur
It’s important to note that for a lot of people, their heel spurs are actually asymptomatic, and the real issue they’re dealing with is plantar fasciitis heel pain.
How do I know if it’s plantar fasciitis or a heel spur?
The only way to confidently answer this is to have your feet assessed, but with that said, while the cause of plantar fasciitis is often associated with biomechanical factors and training factors, a 2022 review of calcaneal (heel) spurs have found that they are associated with a range of conditions including:
- Gout
- Having a high BMI
- Rheumatoid arthritis
- Osteoarthritis
- Ankylosing spondylitis
- Reiter’s disease
- Spondyloarthritis
This means that if you are also living with arthritis or the conditions listed above, it could be worthwhile investigating further if your pain is coming from a heel spur (that can be identified via x-ray), particularly if you haven’t responded to the standard treatment protocols for heel pain.
What Should I Do About My Heel Spur?
Regardless of whether you’re suffering from a heel spur or you have plantar fasciitis heel pain, your symptoms (or the spur itself) won’t go away on its own. This is where professional treatment with your podiatrist will work to effectively fix the problem and relieve your painful symptoms. You can see our approach to treating heel spurs in our clinic here.
Ignoring your heel pain gives a good chance that your pain will persist and may even worsen to limit what you can do on a daily basis, which is why we always recommend promptly treating any heel pain that develops. If your heel spur is detected accidentally without any pain or symptoms, then treatment is not indicated for the spur itself, as your body is already managing the spur without any issues. In this case, it is likely that the spur may remain and not cause you any problems going forwards.