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Heel Spur Pain, Treatment & Surgery Information

The heel is designed to absorb tremendous stress. Attached to the heel are strong bands of ligaments and muscles that help support the arch. If there is too much pressure on the heel bone at the attachment of these structures, a heel spur can form. Another new theory of heel spur formation suggests that the heel spur results from small fractures or cracks that occur in the bone. The spur, which is actually a shelf of bone across the entire length of the heel should not be confused with arthritis. It is caused by excessive pressure on the heel bone, whereas arthritic spurs usually affect multiple areas and are associated around joints.

Conservative care for a heel spur includes one or more injections of steroids to help reduce inflammation or arch supports to help decrease the pressure on the ligaments and muscles. Surgery on the heel spur relaxes the bands of ligaments where they attach as well as smoothing down the bone. After heel spur surgery, walking with crutches is usually necessary for a few days as a regular part of treatment. Regular shoes are used after two to three weeks. Soft, shock-absorbing orthotics are used to reduce the risk of re-growth.

Two other kinds of spurs can develop on the back of the heel. One, originally called a pump bump because it was thought to be from shoe pressure from pump-style shoes, is located where the Achilles tendon attaches to the back of the heel. The other spur is located further down the heel. Just like the spur that forms on the bottom of the heel, these spurs can cause pain and problems wearing shoes. Conservative care includes using heel cushions to lift the heel away from the back of the shoe. Steroid injections, commonly used for the heel spur on the bottom of the foot, are rarely used in this area because it may weaken the Achilles tendon. Heel spur surgery removes the spur. Inflammation of the tendon may develop following surgery, but this gradually resolves.

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