Heel Spurs: Symptoms, Causes, and Relief Strategies
Updated: 2 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Quick Answer: 5 Key Facts
A heel spur is an extra growth of bone where the heel bone meets the plantar fascia, formed in response to long-term strain or inflammation. Most people with heel spurs feel no pain from the growth itself; discomfort usually comes from plantar fasciitis. Spurs are permanent, but more than 90% of people improve with simple treatments like rest and stretching. [1] [2]
What the research says
Spurs are more common in people with heel pain, but they are only part of the picture. A systematic review and meta-analysis of 42 imaging studies (2,928 participants) found that people with plantar heel pain were more likely to have a plantar calcaneal spur on X-ray, along with a thickened plantar fascia and a thicker loaded heel fat pad. Only 21% of the studies were rated good quality. (Drake et al., J Foot Ankle Res, 2022) [3]
Foot orthoses give modest pain relief. A meta-analysis of 19 randomized trials (1,660 participants) found moderate-quality evidence that foot orthoses reduced pain more than sham orthoses in the medium term (7 to 12 weeks; standardized mean difference -0.27, 95% CI -0.48 to -0.06), although it is uncertain whether the change is clinically important. Evidence for short- and longer-term benefit was very low quality, and custom and prefabricated orthoses performed no differently. (Whittaker et al., Br J Sports Med, 2018) [4]
No single treatment has been proven best. A network meta-analysis of 31 randomized trials (2,450 patients) found no evidence that any commonly used treatment for plantar heel pain is better than another. Corticosteroid injections (alone or with exercise) and shockwave therapy ranked most likely to be effective, while exercise appeared beneficial only for long-term pain or function. (Babatunde et al., Br J Sports Med, 2019) [5]
What Is a Heel Spur?
A heel spur, also known as an osteophyte or calcaneal spur, is a bony protrusion that pokes out from the bottom of the heel bone (calcaneus). It typically forms at the point where the heel bone meets the plantar fascia, the thick band of tissue that runs along the bottom of the foot to the ball. Approximately 15% of people have heel spurs, though many are unaware of them until they seek help for persistent heel pain. [1]
These growths develop slowly over time and are not an immediate result of a single injury. Instead, they are a chronic response to long-term stress. A spur can be removed surgically, but doctors almost always recommend non-invasive treatments to manage symptoms, because the spur itself is rarely the primary source of pain. [1] [2]
Feature | Heel Spurs | Plantar Fasciitis |
Definition | A physical bony growth on the heel bone. | Inflammation or tearing of the foot ligament. |
Pain level | Often painless on its own. | Typically causes intense, stabbing pain. |
Permanence | Permanent unless surgically removed. | Can improve with rest and therapy. |
Diagnosis | Confirmed with X-ray imaging. | Diagnosed through physical exam and history. |
The Link Between Spurs and Plantar Fasciitis
Heel spurs and plantar fasciitis are distinct conditions, but they are deeply interconnected. Plantar fasciitis occurs when the ligament on the bottom of the foot is overused, leading to stretching, microscopic tears and inflammation. When this stress becomes chronic, the body responds by building extra bone tissue at the site of tension. [1]
That extra tissue eventually becomes a heel spur. Because the two conditions often coexist, the stabbing pain people associate with a "spur" usually comes from the inflamed ligament. The American Academy of Orthopaedic Surgeons notes that most people who have bone spurs on their heels do not have heel pain, and that spurs do not cause plantar fasciitis pain. [2] The most effective way to treat heel spur pain is therefore to address the plantar fasciitis behind it.
Typical plantar fasciitis symptoms include pain on the bottom of the foot near the heel, pain with the first few steps after getting out of bed or after a long period of rest (usually easing after a few minutes of walking), and more pain after, rather than during, exercise. [2]
Common Causes and Risk Factors
Heel spurs are primarily caused by repetitive strain on the foot's ligaments and tendons. This can occur through repeated tearing of the lining that covers the heel bone, or through gait disorders: conditions that affect your balance and coordination and change how you walk. [1]
Modifiable Risk Factors
Several everyday factors can increase the strain on your heels. Running or jogging on hard surfaces like pavement, wearing shoes that lack proper arch support, and walking barefoot on hardwood or tile floors all place extra stress on the heel. Carrying excess body weight or spending long hours on your feet can add to that load over time. [1] [2]
Non-Modifiable Risk Factors
Some risks come with biology and aging. As we age, the plantar fascia becomes less flexible and more prone to damage, and the natural fat pads on the bottom of the feet gradually thin, reducing the foot's built-in shock absorption. Flat feet or high arches also raise the risk because pressure is distributed unevenly across the foot. [1]
Diagnosis and Effective Treatment
Healthcare providers typically diagnose heel spurs through a physical exam and a review of your medical history, including activities that may have caused the heel pain. Because the growth is internal, an X-ray is the definitive test that confirms a spur. [1] Talk to your provider if treatment for heel pain does not seem to help, since ongoing pain may mean it is time to try other treatments or check for other problems. [1]
Non-Surgical Treatments
Heel pain blamed on a spur is usually caused by plantar fasciitis, so treatment focuses on easing that inflammation and stress: [1]
Rest and activity modification: Taking a break from high-impact activities like running lets inflamed tissue settle. Low-impact exercise such as cycling or swimming puts less stress on the feet. [1] [2]
Cold therapy: Applying ice to the bottom of the foot helps reduce swelling and ease pain. [1]
Stretching and physical therapy: Regularly stretching the calf muscles and plantar fascia is an important part of relief, and a physical therapist can tailor a program. [2]
Orthotics and support: Well-fitting shoes with arch support, or shoe inserts that cushion the heel, protect the plantar fascia. [1]
Medication: Over-the-counter anti-inflammatory drugs can help with daily discomfort. Ask your doctor before using them for more than a month. [1] [2]
When Is Surgery Necessary?
Surgery to remove a heel spur is rare. It is generally saved for people whose pain remains severe and persistent after about a year of aggressive non-surgical treatment, and a spur is usually removed only as part of a broader plantar fascia release procedure. [1] [2]
Conclusion
Living with a heel spur means focusing on the health of your entire foot. While the growth itself is permanent, the pain associated with it does not have to be. By choosing supportive footwear and managing the underlying stress on your ligaments, most people can stay active with far less discomfort.
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Frequently Asked Questions
Can a heel spur go away on its own?
No. Once a heel spur has formed it is permanent. It will not dissolve or disappear, and surgery is the only way to remove it. [1] Because spurs usually do not hurt, treating the condition that caused the spur (most often plantar fasciitis) is what relieves heel pain.
Why does my heel hurt more in the morning?
Morning heel pain is a classic symptom of plantar fasciitis, which often accompanies heel spurs. The ligament tightens during rest, so the first steps after getting up (or after a long period of sitting) stretch it painfully. The pain usually eases after a few minutes of walking. [2]
Can I get a heel spur from wearing flip-flops?
Unsupportive footwear can contribute. Shoes without arch support, such as flip-flops or flat sneakers, increase the strain on the plantar fascia, and long-term strain is what drives spur formation. Cleveland Clinic advises wearing shoes that fit well and support your arches. [1]
Is it okay to walk barefoot if I have a heel spur?
It is best to avoid walking barefoot on hard floors such as hardwood or tile. Cleveland Clinic recommends wearing slippers or shoes on those surfaces, and supportive footwear at home can help reduce pressure on your heels. [1]
How do I know if I have a heel spur or just a bruise?
A bruise typically improves within a week or two. Heel pain that persists, especially stabbing pain with the first steps of the day, is more likely plantar fasciitis, which can occur together with a spur. An X-ray is the test that confirms a spur, [1] so see a doctor if the pain lasts.
Does weight loss help with heel spur pain?
Weight loss can help. Losing weight puts less pressure on your feet with every step, and Cleveland Clinic lists it among the changes that reduce your risk of heel spurs. [1] The American Academy of Orthopaedic Surgeons also lists obesity as a risk factor for plantar fasciitis. [2]
Can children develop heel spurs?
Developing heel spurs as a child is uncommon. Heel spurs develop slowly from long-term stress on the foot's ligaments and tendons, and they are far more common in adults, with risk rising as the plantar fascia ages. [1]
Are there specific exercises for heel spurs?
Stretching the calf muscles and the plantar fascia is described by the American Academy of Orthopaedic Surgeons as the most effective way to relieve the tension behind plantar fasciitis pain. [2] A physical therapist can build a program that fits you.
What kind of doctor treats heel spurs?
Podiatrists and orthopedic surgeons are the specialists who most commonly diagnose and treat foot-related bone growths.
Can running cause heel spurs?
Repetitive high-impact activity such as running, especially on hard surfaces, increases the strain on the plantar fascia that can lead to spurs. Cleveland Clinic suggests choosing soft surfaces such as grass or tracks over pavement. [1]
Do all heel spurs require treatment?
No. Many people have heel spurs that never cause pain and are discovered by accident on an X-ray taken for another problem. These do not need treatment. [2]
Can I use a foot massager for heel spurs?
Gentle massage may help relieve the symptoms of plantar fasciitis, but it will not change the physical structure of the heel spur itself.
Is surgery for heel spurs dangerous?
Like any surgery, it carries risks, which is one reason it is rarely done. Surgery is generally saved for people who have not improved after about 12 months of aggressive non-surgical treatment, and most people recover without it. [2]
What is a gait disorder?
A gait disorder is an abnormality in the way you walk, often because an illness or condition affects your balance and coordination. [1] Cleveland Clinic lists gait disorders among the causes of heel spurs.
Can high arches cause heel spurs?
High arches and flat feet are both listed as risk factors, because they change how weight is distributed across the foot and strain the points where ligaments attach to bone. [1] [2]
References
Cleveland Clinic. Heel Spurs: Symptoms, Causes, and Treatment. Cleveland Clinic. Last updated October 19, 2021. https://my.clevelandclinic.org/health/diseases/21965-heel-spurs
American Academy of Orthopaedic Surgeons. Plantar Fasciitis and Bone Spurs. OrthoInfo. Accessed October 15, 2026. https://www.orthoinfo.org/diseases--conditions/plantar-fasciitis-and-bone-spurs/
Drake C, et al. Medical imaging for plantar heel pain: a systematic review and meta-analysis. J Foot Ankle Res. 2022;15(1):4. PMID 35065676. https://doi.org/10.1186/s13047-021-00507-2
Whittaker GA, et al. Foot orthoses for plantar heel pain: a systematic review and meta-analysis. Br J Sports Med. 2018;52(5):322-328. PMID 28935689. https://doi.org/10.1136/bjsports-2016-097355
Babatunde OO, et al. Comparative effectiveness of treatment options for plantar heel pain: a systematic review with network meta-analysis. Br J Sports Med. 2019;53(3):182-194. PMID 29954828. https://doi.org/10.1136/bjsports-2017-098998
Medical disclaimer
This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. If you think you may have a medical emergency, call your doctor or your local emergency number immediately.
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