Heel Spurs

Common Symptoms

• Heel pain that's often sharpest with the first steps in the morning
• Pain that's frequently indistinguishable from plantar fasciitis, since the two conditions commonly occur together
• Tenderness when pressing on the bottom of the heel
• Pain that eases somewhat with movement, then returns after standing or activity
• In many cases, no pain at all, despite a spur being visible on X-ray

Why It Happens

Heel spurs are thought to form gradually in response to chronic traction at the point where the plantar fascia (and sometimes the Achilles tendon, on the back of the heel) attaches to the calcaneus. This same chronic strain is also the process behind plantar fasciitis, which is why the two conditions are so closely linked — but the spur itself is a bone response to that strain, not the direct cause of most patients' pain.

Why It Can Become Persistent

A heel spur is a fixed bony structure, so it doesn't resolve with rest the way soft-tissue irritation can — and because the pain most people experience is coming from ongoing soft-tissue strain (plantar fasciitis) around the spur rather than the bone itself, focusing treatment only on "the spur" rather than the surrounding soft tissue is a common reason symptoms don't improve.

Who Commonly Gets It

Heel spurs are common in the same population that develops plantar fasciitis: runners and other athletes, people who stand for long periods at work, and adults in midlife generally. Spur formation also becomes more common simply with age.

How It Is Usually Diagnosed

A heel spur is typically identified on X-ray, often incidentally while evaluating heel pain for another reason. Because so many people with spurs have no pain, and many people with heel pain have no spur, your provider's physical exam — checking for tenderness in the soft tissue versus directly on bone, and assessing foot mechanics — is usually more clinically useful than the X-ray finding alone for guiding treatment.

Traditional Treatment Options

• Treatment directed at the soft tissue (usually plantar fasciitis): Because the spur itself is rarely the direct pain generator, first-line care typically targets the surrounding plantar fascia — stretching, supportive footwear, and activity modification.
• Physical therapy: Targeted stretching and strengthening for the foot and calf, matching standard plantar fasciitis care.
• NSAIDs: Sometimes used short-term for symptom control.
• Corticosteroid injection: Can reduce pain in the short term for some patients.
• Surgical spur removal: Rarely performed and reserved for a small subset of cases, since removing the spur alone often does not resolve pain if the underlying soft-tissue process isn't also addressed.

Why Someone Might Start Looking for Another Option

Many people are told they have "a heel spur" and understandably assume the bone itself needs to be treated or removed, then feel stuck when spur-focused care (or simply resting) doesn't help. Understanding that the soft tissue is usually the real target changes what treatment options make sense to explore.

Where Shockwave Therapy May Fit

Because heel-spur-associated pain overlaps so heavily with plantar fasciitis, the well-established shockwave research for plantar fasciopathy is directly relevant here. There is also a specific, older conference-presented comparison of focused versus defocused shockwave therapy for heel spur-associated pain, though that record is preliminary and not independently peer-reviewed.

How Shockwave Treatment Works for This Area

Acoustic pressure waves are directed at the tender soft tissue near the spur — typically the plantar fascia insertion — rather than at the bone itself, consistent with the understanding that soft tissue, not the spur, is usually the source of pain.

What the Treatment Feels Like

Most patients describe a firm, rhythmic pressure or tapping sensation at the treatment site, with some tenderness during treatment, particularly directly over the sore spot on the heel.

What Happens During Your First Visit

Your visit begins with a provider evaluation focused on your history and a physical exam relevant to your complaint. If shockwave therapy is determined to be clinically appropriate, your first treatment can typically be provided the same visit. See our What to Expect page for the full walkthrough.

Who May Not Be Appropriate

• People who have not yet had a medical evaluation to confirm the actual cause of their heel pain
• Certain circulatory, neurological, or bleeding-related conditions, per your provider's screening
• Pregnancy, in the treatment area, unless specifically cleared by your provider
• Active infection, open wounds, or certain bone conditions at the treatment site

This list is not exhaustive. Your provider will screen for contraindications during your evaluation.