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Waking up to a sharp jolt of pain with your first steps of the day? That stubborn ache in your heel may be more than just a fleeting annoyance. This persistent discomfort is often your body’s way of flagging an underlying issue. It could be a sign of a heel bone spur forming at the base or back of your feet.
For runners, athletes, and anyone who is constantly on their feet, a heel bone spur can quickly transition from a mild nuisance to a limiting, chronic condition. To get ahead of it, you need to understand what’s happening inside your foot, and more importantly, what can be done to ease the discomfort and prevent it from coming back. That’s where physiotherapy comes in, offering more than just temporary relief for bone spurs on the back of the heel.
Heel Bone Spurs
A heel bone spur, medically known as a calcaneal spur, is a bony outgrowth that forms slowly over time from calcium deposits, typically where the plantar fascia attaches to the heel bone. These hook-shaped growths, visible on X-rays, don’t pierce tissue but align with the plantar fascia’s natural fibers. Heel spurs can also form at the back of the heel due to a strain on the Achilles tendon.
While up to 15% of people have heel spurs, fewer than 5% develop noticeable symptoms, suggesting the spur itself isn’t usually the main problem. Instead, pain typically comes from underlying inflammation, most often plantar fasciitis, that leads to spur formation through microtears and repetitive stress, causing gradual calcification. This causes back of heel pain from bone spurs, though the spurs are not necessarily the direct culprit.
Understanding these causes and treatment options is key to managing symptoms, preventing long-term issues and restoring quality of life.
What Causes The Growth of Bone Spurs On The Heel?
Heel bone spurs develop from repetitive stress on the plantar fascia and surrounding muscles. The body responds to this stress with inflammation as a protective mechanism, which can lead to the formation of heel spurs. Activities that put excessive stress on the feet, such as running and jumping, especially on hard surfaces, increase the risk of developing heel spurs.
Other risk factors for developing heel spurs include flat feet, high arches and ageing. These conditions can alter the mechanics of the foot, increasing the risk of strain and injury. As heel spurs develop, addressing risk factors and modifying activity is key to prevention. Gait disorders that affect balance and coordination can also contribute to the development of heel spurs.
What Are the Symptoms of a Heel Bone Spur?
Identifying the symptoms of a heel bone spur can be tricky, as many cases are painless. In fact, most heel spurs are painless and are often discovered incidentally. Frequently, plantar fasciitis pain is mistaken for pain from the spur itself, though it stems from the inflammation of the plantar fascia. The hallmark sign is a sharp, stabbing pain that occurs with your first steps in the morning. This pain typically eases into a dull ache as you move, and then flares up again after prolonged periods of sitting or standing.
The pain is typically most intense after rest, and many describe it as feeling like repeatedly stepping on a pebble, especially when barefoot on hard floors. As the plantar fascia warms up, the pain often lessens. However, prolonged activity can cause it to return.
For those with a spur on the back of the heel, symptoms may differ. These spurs form near the Achilles tendon and often cause pain during movements that involve the calf, such as running uphill or climbing stairs. Back of heel pain from a spur can worsen with stiff shoes or any other activity that presses directly on the area.
Diagnosis of Heel Bone Spurs
The diagnosis of heel bone spurs typically begins with a thorough medical history and physical examination. During the examination, a healthcare provider will assess the patient’s joint range of motion, muscle strength, and evaluate their gait for signs of inflammation or swelling in the foot and ankle.
X-rays are used to identify heel bone spurs, as these scans can reveal bony growths that may not be visible during a physical examination. Interestingly, incidental findings of heel spurs are common. Studies suggest almost 11% of adults may have an asymptomatic bone spur visible on X-rays.
If heel pain persists after initial treatment, further evaluation, such as an MRI scan, may be necessary to rule out other conditions and ensure proper diagnosis. An accurate diagnosis is crucial for determining the most effective heel bone spur treatment.
Can A Heel Bone Spur Heal By Itself?
Heel bone spurs themselves do not “heal” or dissolve on their own. The spurs are permanent bony growths that remain unless surgically removed. However, the symptoms they cause, such as pain, inflammation and functional limitations, can often improve or resolve with conservative non-surgical treatment. Conservative treatment and non-surgical options, such as orthotics, medications, stretching exercises, and rest, are typically effective in managing symptoms.
This is because the pain isn’t caused by the spur itself but rather by the soft tissue irritation and inflammation in surrounding structures such as the plantar fascia or Achilles tendon. When the underlying causes (such as poor biomechanics, overuse, muscle tightness or improper footwear) are addressed, symptoms often subside even though there is no healing heel bone spurs.
Managing Chronic Heel Bone Spur Pain
Chronic heel bone spur pain can significantly impact daily life and requires a comprehensive management approach that addresses both the spur and underlying conditions.
Some of the most effective options include:
- Conservative Treatment Physical therapy is essential for strengthening foot muscles, improving flexibility, and correcting gait problems. Regular stretching of the plantar fascia and calf muscles also helps reduce tension and prevent further heel irritation. Supportive shoes and custom orthotics provide proper cushioning and alignment, minimising impact on the affected foot.
- Advanced Options If conservative treatments fail, surgical removal of the bone spur or plantar fascia release may be necessary for chronic pain relief.
- Lifestyle Management Maintaining a healthy weight, wearing proper footwear and avoiding high-impact activities can all ease undue stress on the heel.
Working with a physiotherapist to develop a personalised treatment plan ensures your approach fits your specific needs and helps restore mobility and improve quality of life.
Advanced Heel Spur Treatment
Advanced technologies like INDIBA® Activ therapy accelerate healing through the application of radiofrequency energy, which stimulates cellular regeneration and improves blood circulation. This non-invasive treatment penetrates deeply into tissues, creating a gentle warming sensation and providing immediate relief while promoting natural healing processes. The improved circulation and cellular activity complement traditional physiotherapy interventions, like physical therapy.
Shockwave Therapy delivers precisely controlled acoustic waves that promote tissue regeneration and break down calcium deposits. Focal shockwaves deliver intense, targeted energy for stubborn spurs, while radial shockwaves provide broader treatment coverage with improved tolerance for sensitive patients. Both modalities of Shockwave Therapy stimulate the formation of new blood vessels, enhance cellular metabolism, and trigger the release of natural pain-relieving substances, creating an optimal healing environment.
Stretches for Bone Spurs in the Heel
Incorporating specific stretches into your daily routine is one of the most effective ways to treat and prevent heel bone spurs. These targeted exercises address the muscle tightness and fascial restrictions that cause excessive stress on the heels. Doing these exercises correctly and regularly can significantly improve your symptoms and prevent the recurrence of heel spurs.
Calf muscle stretching is the foundation of any effective heel spur exercise program. Tight calf muscles create increased tension on the plantar fascia, especially during the push-off phase of walking and running. The traditional wall push-up stretch, where you place your hands against a wall and step back with one foot while keeping the heel down, is a good starting point. However, variations that target both the gastrocnemius and soleus muscles offer more benefits. Ask your physiotherapist for guidance on how to modify the calf muscle stretch to suit your specific needs.
The towel stretch is a convenient way to address plantar fascia tightness first thing in the morning. Before getting out of bed, loop a towel around the ball of your foot and gently pull your toes towards your body while keeping your knee straight. This gentle stretch prepares the plantar fascia for weight-bearing activities and can significantly reduce the characteristic morning pain associated with plantar fasciitis. Rolling your foot over a tennis ball or a frozen water bottle while applying moderate pressure helps break up fascial adhesions and improve tissue flexibility. The contrast between the firmness of a tennis ball and the cold of a frozen bottle provides additional therapeutic benefits when used alternately.
Sports Taping and Supportive Interventions
Sports taping provides immediate support and pain relief by reducing stress on the plantar fascia and improving foot mechanics through proprioceptive feedback. Low-dye taping is the most common technique. This method uses tape strips to lift the arch and minimize tension during weight-bearing activities. When applied correctly, patients often experience immediate pain relief, making it an excellent choice for managing acute symptoms.
Kinesiology taping provides longer-term support that can be worn for several days, allowing for a full range of motion. This elastic tape is ideal for active individuals, as it reduces swelling, improves circulation, and provides gentle support without restricting exercise routines.
Insoles and Orthotic Support
Insoles address abnormal foot mechanics by redistributing pressure and reducing stress on the plantar fascia, thereby improving foot alignment and managing the cause of your heel spurs. Quality insoles provide arch support and cushioning that corrects biomechanical imbalances, which can cause heel pain.
For heel spur patients, therapeutic insoles often include specialized heel accommodations such as gel pads or softer materials placed under the affected area. While over-the-counter options can provide relief, professionally fitted insoles offer superior support tailored to individual needs.
When Surgery is Necessary
In some cases, surgery may be necessary to address heel bone spurs, especially when conservative treatments have failed to provide adequate pain relief after 9 to 12 months. Surgical options include procedures such as needle aspiration of calcific deposits, plantar fascia release and spur removal.
The recovery outlook after heel spur surgery is generally good, provided that proper postoperative care is followed. However, it’s important to consider the risks associated with surgical treatments, such as tibial nerve damage or calf weakness from procedures like gastrocnemius recession.
Consulting with a physiotherapist can help determine the best course of action for your specific condition.
Preventing Heel Bone Spurs
Preventing heel bone spurs begins with taking proactive steps through lifestyle modifications and selecting proper footwear. These include:
- Selecting shoes with adequate arch support can help reduce the risk of developing heel spurs and heel pain.
- Stretching your legs and feet before physical activities can minimize heel strain and prevent heel spurs.
- Gradually increasing your activity levels instead of making sudden changes to manage heel pain and prevent heel bone spurs from forming.
- Ensuring you run or jog on softer surfaces, such as grass or dirt, rather than hard pavements, to lower the risk of heel spur formation.
- Managing your weight to reduce the stress on the heels and prevent heel bone spurs.
By doing these preventive measures, you can protect your feet and be active without worrying about painful heels. Working with healthcare professionals, such as podiatrists and physiotherapists, can also address biomechanical issues like overpronation and prevent heel spurs, thereby reducing the need for heel spur treatment later on.
HelloPhysio’s Advantage in Healing Heel Bone Spurs
Heel bone spurs can be a source of pain and discomfort. Understanding their causes, symptoms and treatment options can help you manage and prevent them. From conservative treatments like NSAIDs and physical therapy to innovative techniques like Extracorporeal Shockwave Therapy, there are many ways to get relief.
Take proactive measures, such as wearing supportive shoes and maintaining a healthy weight, to prevent heel spurs and keep your feet healthy. Remember, early intervention and proper care are crucial for managing heel pain and maintaining an active lifestyle.
Don’t let heel pain limit your activities and quality of life. Contact HelloPhysio today to schedule your comprehensive assessment and start your journey to long-term relief from heel bone spur pain.
