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

The plantar heel spur — a bony projection from the anterior inferior calcaneal tuberosity at the attachment of the plantar fascia and intrinsic foot muscles — is one of the most commonly identified and most misunderstood findings in foot X-rays. Patients frequently attribute all their heel pain to ‘the heel spur,’ and some request spur removal as treatment. A proper understanding of the true relationship between heel spurs and plantar fasciitis pain — and the role of spur removal in surgical treatment — is essential for appropriate patient counseling.

What Heel Spurs Actually Are

A calcaneal spur is reactive bone formation within the origin of the plantar fascia or the flexor digitorum brevis, produced by the chronic traction stress of the plantar fascia at its calcaneal attachment — analogous to the bone spurs that form at other tendon insertions under chronic stress. Heel spurs are present in 50% of patients with symptomatic plantar fasciitis on X-ray, but they are also present in 15–25% of asymptomatic people who have never experienced heel pain. This observation — that spurs are equally prevalent in many people with and without heel pain — demonstrates that the spur itself is not the cause of plantar fasciitis pain. The pain of plantar fasciitis comes from degeneration and micro-tearing at the plantar fascia insertion, not from the spur pressing on nerves or skin. Infracalcaneal spur vs. retrocalcaneal spur: infracalcaneal (inferior) spur is associated with plantar fasciitis; retrocalcaneal spur (posterior calcaneus at the Achilles tendon insertion) is associated with insertional Achilles tendinopathy and Haglund’s deformity.

Spur Removal in Surgical Treatment

The role of spur excision in surgery for chronic plantar fasciitis is controversial — in the traditional open plantar fasciotomy, the spur is often removed as part of the procedure; in endoscopic plantar fasciotomy, the spur is not removed and outcomes are equivalent. Multiple studies comparing plantar fasciotomy with vs. without spur excision show no significant difference in outcomes — confirming that the spur is not the pain generator. The pain relief from surgery comes from fascial release, not spur removal. Clinical implication: surgically resecting a heel spur in isolation (without addressing the plantar fascia) is not a recognized or evidence-based treatment for plantar fasciitis pain. Dr. Biernacki at Balance Foot & Ankle provides patient education about heel spurs as part of every plantar fasciitis consultation, ensuring patients understand the true cause of their heel pain. Call (810) 206-1402 at our Bloomfield Hills or Howell office.

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Frequently Asked Questions

What is the fastest way to relieve plantar fasciitis pain?

The most effective immediate relief comes from targeted calf and plantar fascia stretches, supportive footwear with adequate arch support, and custom orthotics to offload the inflamed fascia. Most patients see significant improvement within 4–6 weeks with this combination.

Will plantar fasciitis go away on its own?

It can, but typically takes 6–18 months untreated and may become chronic. Professional treatment with custom orthotics, stretching protocols, and in some cases shockwave therapy or PRP significantly shortens recovery time.

Do I need surgery for plantar fasciitis?

Surgery is rarely needed — only about 5–10% of patients who don’t respond to 6–12 months of conservative care. The vast majority resolve with orthotics, stretching, and non-surgical treatments.

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Dr. Tom Biernacki, Dr. Carl Jay, and Dr. Daria Gutkin see patients at our Howell and Bloomfield Township offices.

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Heel Spur & Plantar Fasciitis Treatment in Michigan

Balance Foot & Ankle clarifies the relationship between heel spurs and plantar fasciitis and provides targeted treatment. Most heel spur pain comes from the fascia, not the spur itself.

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Clinical References

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

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Dr. Tom Biernacki, DPM

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Dr. Carl Jay, DPM

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Dr. Daria Gutkin, DPM

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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.