Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Hills, MI. Last updated April 2026.

Heel spurs — calcium deposits on the inferior calcaneus visible on X-ray — are among the most misunderstood findings in podiatric practice. They are frequently blamed as the primary cause of heel pain, and patients sometimes request surgical spur removal expecting this to be the definitive solution. Understanding what heel spurs actually represent, their relationship to pain, and the narrow circumstances in which surgery targeting the spur itself is appropriate, helps patients make better-informed treatment decisions.

What Heel Spurs Actually Are

Inferior calcaneal spurs form at the origin of the plantar fascia or intrinsic foot musculature on the calcaneus in response to chronic traction stress. They are the bone’s attempt to reinforce a chronically loaded insertion — bone remodeling triggered by stress, not the cause of the stress itself. This distinction is clinically crucial: heel spurs are found in approximately 40% of patients with plantar fasciitis, but they are also found in an essentially equal proportion of people without any heel pain. The pain of plantar fasciitis originates from the fascia itself (micro-tears, inflammation, degenerative change at the fascial origin), not from the spur pressing on soft tissue. This is confirmed by the fact that successful non-surgical treatment of plantar fasciitis does not require spur resolution — pain resolves while the spur remains unchanged on X-ray.

When Is Heel Spur Surgery Actually Indicated?

There is one specific indication where surgical spur excision has a defined role: a large “traction spur” (also called an enthesophyte) that has fractured or is impinging on a nerve branch — specifically the nerve to the abductor digiti minimi (Baxter’s nerve entrapment). In this situation, the spur represents a structural lesion causing nerve compression, and surgical decompression with concurrent spur removal addresses the pathomechanical cause. This is a minority presentation within the broader heel pain population and requires diagnostic ultrasound or MRI confirmation before surgery is planned.

The Real Surgery for Chronic Plantar Fasciitis

Endoscopic plantar fasciotomy — a partial release of the plantar fascia at its calcaneal origin — is the evidence-based surgical procedure for chronic, refractory plantar fasciitis that has failed 6+ months of comprehensive conservative care. This procedure addresses the actual pathological tissue (the tightened, degenerative fascia) rather than the associated spur. Most surgeons performing this procedure do not remove the spur, and outcomes are equivalent whether or not spur removal is added. At Balance Foot & Ankle, Dr. Biernacki evaluates heel pain with on-site imaging and reserves surgery for patients with confirmed plantar fasciitis or Baxter’s nerve entrapment who have genuinely failed comprehensive conservative management. Call (810) 206-1402 for a heel pain evaluation at our Bloomfield Hills or Howell office.

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When to See a Podiatrist

Many foot conditions can be managed conservatively at home, but some require professional evaluation. See a podiatrist promptly if you experience:

• Pain that persists for more than 2 weeks despite rest
• Swelling, redness, or warmth that isn’t improving
• Numbness, tingling, or burning in the feet
• A wound or sore that is not healing within 2 weeks
• Any foot concern if you have diabetes or poor circulation
• Nail changes that suggest fungal infection or other problems

At Balance Foot & Ankle, our three board-certified podiatrists — Dr. Tom Biernacki, Dr. Carl Jay, and Dr. Daria Gutkin — provide comprehensive foot and ankle care at our Howell and Bloomfield Township offices. Most insurance plans are accepted.

Related Conditions & Resources

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Board-certified podiatrists Dr. Tom Biernacki, Dr. Carl Jay, and Dr. Daria Gutkin see patients daily at our Howell and Bloomfield Township, MI offices.

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Heel Spur Surgery — When Is It Needed?

Most heel spurs never need surgery. Our podiatrists help you understand when conservative treatment is appropriate and the rare cases where surgical intervention makes sense.

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Clinical References

1. Thomas JL, Christensen JC, Kravitz SR, et al. The diagnosis and treatment of heel pain: a clinical practice guideline. J Foot Ankle Surg. 2010;49(3 Suppl):S1-S19.
2. Leach R, Jones R, Silva T. Rupture of the plantar fascia in athletes. J Bone Joint Surg Am. 1978;60(4):537-539.
3. Monteagudo M, Maceira E, Garcia-Virto V, Canosa R. Chronic plantar fasciitis: plantar fasciotomy versus gastrocnemius recession. Int Orthop. 2013;37(9):1845-1850.

Dr. Tom Biernacki, DPM

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Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has reached over one million views.