What Are Heel Spurs? | Bony Growths Under Your Heel

That sharp, stabbing sensation in your heel during those first steps out of bed sends a clear signal: something is wrong inside your foot. While many people immediately blame a “heel spur” they’ve heard about, the reality is more nuanced. Understanding what a heel spur actually is—and what it isn’t—is the first step toward real relief. This article covers how these bony growths form, why they may or may not hurt, and what treatments actually help.

What Exactly Is a Heel Spur?

A heel spur is a pointed bony outgrowth, medically called a calcaneal spur, that develops on the heel bone (calcaneus). The Cleveland Clinic describes it as a bony growth that pokes out below the back heel bone inside the foot, at the point where the heel bone connects to the plantar fascia. The MSD Manuals define it as a calcium deposit forming a spike of extra bone. Two types exist: a plantar heel spur forms under the heel near the plantar fascia attachment, while a posterior heel spur develops at the back of the heel near the Achilles tendon.

How Do Heel Spurs Form?

Heel spurs develop over many months, not overnight. They result from repeated stress and strain on the foot’s ligaments, muscles, and tendon attachments. The most common mechanism involves chronic pulling or micro-tearing at the plantar fascia or Achilles insertion. This triggers inflammation, and the body responds by laying down calcium, eventually forming a bony spur. Some sources describe the spur as the body’s repair response to prolonged or impaired healing—a sign of an ongoing issue rather than the primary problem itself. For those dealing with persistent heel pain, finding the right supportive shoes designed for heel spurs can make a significant difference in daily comfort.

What Symptoms Do Heel Spurs Cause?

Here’s the surprising truth: many people with heel spurs have no symptoms at all. The spur itself often sits silently, discovered only when an X-ray is taken for another reason. When symptoms do occur, people typically report:

• A sharp, stabbing pain in the heel, especially with the first steps in the morning or after sitting for a while
• A dull ache that persists during the day
• Local tenderness, warmth, or swelling at the heel
• Occasionally, a palpable bony bump under the foot

The critical point, shared across multiple medical sources, is that spur size does not reliably match pain severity. Someone with a large spur may feel nothing, while another with a tiny spur may have significant pain from the surrounding soft-tissue inflammation.

What Causes Heel Spurs and How Are They Treated?

The most commonly cited associated condition is plantar fasciitis. Other risk factors include excessive standing or walking, running on hard surfaces, tight calf muscles, obesity, improper foot positioning, and Achilles tendinopathy. Shoes that don’t fit correctly can also contribute.

Diagnosis typically involves an X-ray, though small spurs can be hard to detect. The treatment approach is consistent across all major medical sources: start conservative. Non-surgical management focuses on addressing the underlying condition causing the inflammation, not the spur itself. Effective measures include rest and activity modification, ice application, stretching the calf and plantar fascia, and wearing supportive footwear with good arch support. Anti-inflammatory medications may help during flare-ups. Surgery is reserved for select cases where conservative treatment has failed after a significant trial period. For most people, the pain resolves without ever needing to address the spur directly.