✅ Medically reviewed by Dr. Thomas Biernacki, DPM — Board-Certified Podiatrist · Last updated April 6, 2026

Heel Spurs: Causes, Symptoms & How to Fix Them Without Surgery

Do You Actually Have a Heel Spur?

Heel spurs are one of the most misunderstood conditions in podiatry. I can’t count how many patients have come in convinced that their bone spur is the source of all their pain — when in reality, the spur itself is often not the problem at all. Let me clear up the confusion and tell you what actually works to get rid of heel pain.

What Is a Heel Spur?

A heel spur is a calcium deposit that forms on the underside of the heel bone (calcaneus). It develops gradually over months or years in response to repetitive stress and inflammation — most often from plantar fasciitis. The spur itself is actually the body’s attempt to heal and stabilize the attachment point of the plantar fascia.

Here’s the key fact most patients don’t know: heel spurs are present in about 70% of plantar fasciitis patients — but they’re also found in about 30% of people with NO heel pain at all. What causes your pain is almost always the inflamed plantar fascia, not the bony spur itself.

Symptoms of Heel Spur Pain

Classic symptoms include sharp pain in the heel when taking your first steps in the morning (this is the plantar fascia tearing as it’s stretched for the first time after hours of rest), pain that improves after walking for a few minutes but returns after prolonged standing, tenderness directly on the bottom of the heel, and pain that worsens after (not during) exercise. The pain location — bottom of the heel, toward the front — is characteristic and distinguishes it from Achilles tendonitis, which hurts at the back of the heel.

Best Treatments (Without Surgery)

1. Custom or OTC Orthotics

Orthotics redistribute pressure away from the inflamed area and provide arch support that reduces tension on the plantar fascia. Custom orthotics are made from a 3D scan of your foot — they’re the gold standard for chronic cases. For mild to moderate cases, quality OTC options like Powerstep Pinnacle or PowerStep Pinnacle often work remarkably well.

2. Stretching Protocol

Daily plantar fascia stretching is one of the most evidence-backed treatments. The key stretches: calf wall stretch, towel toe stretch, and the plantar fascia-specific stretch (seated, pulling toes back before taking your first steps). Do these before getting out of bed every morning — this prepares the fascia before it’s forced to bear weight.

3. Night Splints

A night splint holds your foot in a slightly dorsiflexed position while you sleep, keeping the plantar fascia gently stretched overnight. This dramatically reduces that severe morning first-step pain. Studies show night splints resolve symptoms in 80%+ of patients within 3 months.

4. Proper Footwear

Shoes with firm heel counters, adequate cushioning, and arch support are essential. Avoid flat shoes, flip flops, and walking barefoot on hard floors — all of these dramatically increase plantar fascia stress.

5. Anti-Inflammatory Treatment

Ice massage (frozen water bottle rolled under the foot), NSAID medications, and corticosteroid injections can provide significant relief during acute flares. Injections work well but I limit them to 2-3 per year to avoid weakening the plantar fascia.

6. Shockwave Therapy

Extracorporeal shock wave therapy (ESWT) uses sound waves to stimulate healing in chronic cases. It’s FDA-cleared, non-invasive, and has excellent outcomes for heel spurs and plantar fasciitis that haven’t responded to other treatments.

When Is Surgery Necessary?

Surgery is only considered after at least 6-12 months of consistent conservative treatment has failed — and this is rare. Only about 5% of plantar fasciitis cases require surgical intervention. When we do operate, modern minimally invasive techniques have dramatically improved recovery times.

Products Our Doctors Recommend

• Best Night Splints for Plantar Fasciitis — our top picks with patient reviews
• Orthotics & Insoles — OTC options that actually work
• Best Shoes for Heel Pain — footwear guide by condition
• Browse All Products →

Frequently Asked Questions

Can a heel spur go away on its own?

The bony spur itself does not dissolve or disappear. However, the pain associated with it absolutely can resolve completely with proper treatment. Most patients achieve full pain relief without removing the spur surgically.

How do I know if I have a heel spur vs. plantar fasciitis?

You can’t reliably tell the difference without an X-ray — and in many cases, you have both. A heel spur shows up clearly on X-ray as a bony protrusion. Plantar fasciitis is a soft tissue condition visible on ultrasound. Many patients have both simultaneously.

Is walking on a heel spur making it worse?

Walking doesn’t make the bony spur grow. However, walking without proper support does inflame the plantar fascia and can worsen your overall pain. Supportive footwear and orthotics are essential.

How long does heel spur treatment take?

Most patients see significant improvement within 6-8 weeks of consistent treatment. Full resolution typically takes 3-6 months. Chronic cases (more than a year of pain) may take longer.

Are cortisone shots good for heel spurs?

Cortisone injections can provide excellent short-term relief for acute flares. I use them strategically — typically no more than 2-3 per year per foot — to manage pain while other treatments (stretching, orthotics) address the underlying cause.

About the Author: Dr. Tom Biernacki, DPM is a board-certified podiatric surgeon and founder of Balance Foot & Ankle Specialists, with locations in Howell and Bloomfield Hills, Michigan. He has treated over 5,000 patients and his YouTube channel has been viewed over 1 million times.

Related Treatment Guides

• Plantar Fasciitis & Heel Pain Treatment
• Custom 3D Orthotics
• Sports Foot & Ankle Injury Treatment
• Bunion Treatment

Medical References & Sources

• American Podiatric Medical Association — Patient Education
• American Orthopaedic Foot & Ankle Society — Foot Conditions

Clinical References

1. Menz HB, et al. “Plantar calcaneal spurs in older people: longitudinal traction or vertical compression?” Journal of Foot and Ankle Research. 2008;1:7.
2. Johal KS, Milner SA. “Plantar fasciitis and the calcaneal spur: fact or fiction?” Foot and Ankle Surgery. 2012;18(1):39-41.
3. Thomas JL, et al. “The diagnosis and treatment of heel pain: a clinical practice guideline.” Journal of Foot and Ankle Surgery. 2010;49(3):S1-S19.

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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.