HEEL SPUR
Heel spur – a painful irritation at the tendon
A heel spur is a bony outgrowth (an exostosis) on the heel bone (calcaneus), which usually forms where tendon-like structures place sustained traction on the bone. The most common form affects the attachment of the plantar fascia on the underside of the heel – this is known as a plantar heel spur. Less common is the cranial (posterior) heel spur, which occurs where the Achilles tendon attaches. The pain is not caused by the bony outgrowth itself but by inflammatory irritation of the surrounding tendons, fascia or bursae. Doctors therefore often speak of plantar fasciitis with or without a heel spur.
How does a heel spur develop?
A heel spur develops as a result of chronic mechanical overloading. The body responds to the sustained traction at the tendon attachments by forming bone.
- Foot deformities (for example flat foot with valgus, splay foot)
- Excess weight – greater pressure and traction forces in the foot
- Unsuitable footwear – unpadded, hard or overly tight shoes
- Overloading through prolonged standing, walking or sporting activity (for example jogging, jumping)
- Degenerative changes in later life
Symptoms
A heel spur can be symptom-free. Typically, however, there is a localised stabbing or burning pain under the heel, particularly when the foot is loaded.
First-step pain
Stabbing pain on standing up or after sitting for a while is typical.
Tenderness on pressure
There is typically localised tenderness right where the plantar fascia attaches under the heel.
Pain on weight-bearing
The pain increases noticeably when walking on hard surfaces.
Treatment options for a heel spur
Treatment of a heel spur is aimed above all at relieving pain, reducing inflammation and taking the load off the irritated structures – particularly the plantar fascia or the Achilles tendon. Treatment is usually non-surgical. Only in rare cases that do not respond to treatment is surgery necessary.
Treatment options
Non-surgical and surgical – we will find the right approach for you
Taking the load off and adapting footwear
Softly padded, well-cushioned shoes and suitable insoles take the load off the painful heel where it matters.
Medication
Non-steroidal anti-inflammatory drugs (NSAIDs, for example ibuprofen or diclofenac) to relieve pain and reduce inflammation
Physiotherapy and home exercises
Targeted stretching, muscle strengthening and fascia mobilisation improve load tolerance and reduce the tension on the irritated plantar fascia.
Extracorporeal shockwave therapy (ESWT)
Extracorporeal shockwave therapy (ESWT) can relieve chronic heel pain by stimulating blood flow and supporting healing at the tendon attachment.
Frequently asked questions about heel spurs
What exactly is a heel spur?
Is the heel spur itself the cause of the pain?
Do I always need to see a doctor about heel pain?
How much does footwear matter?
Does shockwave therapy help?
When is surgery necessary?
How long does it take to heal?
Our foot specialists
Experienced consultants for heel spurs and foot surgery
