A heel spur and plantar fasciitis are not the same thing, though they often occur together. The spur is a bony growth that may develop as a result of plantar fasciitis, but it’s rarely the actual cause of your heel pain.
The Confusion That Brings Most People to Our Clinic
You’ve had an X-ray. The radiologist’s report mentions a “calcaneal spur” or “heel spur.” Suddenly, you’re convinced that this sharp piece of bone is stabbing into your heel with every step. You start googling whether you need surgery to remove it.
Here’s what catches nearly everyone off guard: that spur probably isn’t causing your pain at all.
At Happy Feet Podiatry, we see this misunderstanding almost daily. Patients arrive clutching their X-ray reports, pointing to the spur, asking when we can remove it. The reality is far more interesting than most people expect.
What’s Actually Happening in Your Heel?
Plantar fasciitis is an overuse injury affecting the thick band of tissue (the plantar fascia) that runs along the bottom of your foot from your heel to your toes. When this tissue becomes irritated and inflamed from excessive strain, you get that characteristic stabbing pain near the heel.
A heel spur, on the other hand, is your body’s response to chronic pulling and tension at the point where the plantar fascia attaches to your heel bone. Over months or years of stress, calcium deposits form and create a small bony projection. Think of it like a callus, but made of bone instead of skin.
The spur develops because of the plantar fasciitis, not the other way around. And here’s the kicker: plenty of people walk around with heel spurs and have absolutely no pain. Studies show that up to 50% of people with heel spurs experience no symptoms whatsoever.
So Why Does My Heel Hurt So Much?
The pain you’re feeling comes from the inflamed plantar fascia tissue itself, not from the bony spur poking into anything. The fascia becomes irritated through:
- Repetitive stress from standing, walking, or running on hard surfaces
- Sudden increases in activity levels
- Poor footwear that doesn’t support your arch properly
- Tight calf muscles that increase tension on the fascia
- Being overweight, which adds extra load to the tissue
- Foot mechanics that place excessive strain on the fascia
That classic first-step-in-the-morning agony? That’s the inflamed fascia tightening up overnight and then being suddenly stretched when you stand. The spur just sits there, minding its own business.
Does the Spur Need to Come Out?
Almost never. Surgery to remove a heel spur is rarely necessary because, again, the spur isn’t typically the source of your pain. Removing it won’t fix the underlying plantar fasciitis problem.
We follow evidence-based treatment approaches, and the research is clear: conservative treatment resolves plantar fasciitis in about 90% of cases within 6 to 12 months. Surgery is reserved for the small percentage of people who don’t respond to comprehensive conservative care after at least 12 months.
Even when surgery is considered, modern procedures focus on releasing the tight plantar fascia rather than removing the spur itself. The spur removal might happen as part of the procedure, but it’s not the primary goal.
How Do You Actually Fix This?
Since we’re treating the plantar fasciitis rather than obsessing over the spur, heel spur vs plantar fasciitis treatment at Happy Feet Podiatry focuses on reducing the load and irritation on that inflamed tissue.
The most effective approaches include:
- Stretching exercises: Specific stretches for your calf muscles and plantar fascia help reduce tension. These need to be done consistently, usually twice daily.
- Footwear modifications: Proper arch support and cushioning reduce strain on the fascia. Your worn-out thongs aren’t doing you any favours.
- Custom orthotics: Professionally made devices that support your foot’s unique structure and reduce excessive pronation or other mechanical issues.
- Taping or strapping: Provides temporary support and can offer immediate relief while other treatments take effect.
- Activity modification: This doesn’t mean stopping everything, but rather being strategic about what you do and how much.
- Shockwave therapy: A newer treatment option that uses acoustic waves to stimulate healing in chronic cases.
The key is addressing the root cause. If your foot mechanics are contributing to excessive strain on the plantar fascia, simply resting won’t provide a long-term solution. You need to change the forces acting on that tissue.
What About Those Injections I’ve Heard About?
Corticosteroid injections can provide temporary pain relief by reducing inflammation, but they’re not a cure. The injection might help you get through a particularly rough patch or allow you to engage more effectively with physiotherapy exercises, but the underlying problem still needs addressing.
There’s also some evidence that repeated corticosteroid injections may weaken the plantar fascia tissue over time, so they’re used judiciously. Your podiatrist will discuss whether this option makes sense for your specific situation.
How Long Until I Feel Better?
This is the question everyone wants a definitive answer to, but plantar fasciitis recovery timelines vary significantly. Some people notice improvement within a few weeks of starting treatment, while others take several months.
According to research published in Australian medical journals, most people see substantial improvement within three to six months with appropriate treatment. The catch is “appropriate treatment” means actually doing the exercises, wearing the recommended footwear, and following through with the treatment plan.
The people who struggle most are often those who do the exercises sporadically or give up after a few weeks because they don’t see immediate results. Tissue healing takes time.
When Should You Actually See a Podiatrist?
If you’ve got heel pain that’s lasted more than a couple of weeks, it’s worth getting properly assessed. Many people wait months, hoping it will resolve on its own, only to end up with a more chronic problem that takes longer to fix.
A podiatry assessment involves looking at your foot structure, your walking pattern, your footwear, and your activity levels. We can identify the specific factors contributing to your plantar fasciitis and create a targeted treatment plan. Under Medicare, you may be eligible for a rebate on podiatry services if you have a chronic condition and a GP management plan.
You can find more information about plantar fasciitis through Health Direct’s plantar fasciitis resource, which provides evidence-based information for Australian patients.
The Bottom Line on Spurs and Fasciitis
If you’ve been told you have a heel spur, don’t panic about needing surgery. Focus instead on treating the plantar fasciitis that’s causing your pain. The spur is just an innocent bystander that showed up on your X-ray.
The good news is that with proper treatment, most people recover fully and return to their normal activities. The key is starting treatment early, being consistent with your exercises, and working with a podiatrist who can address the specific factors contributing to your condition.
Frequently Asked Questions
Can a heel spur go away on its own?
No, a heel spur is a permanent bony growth that won’t disappear. However, this doesn’t matter because the spur itself rarely causes pain. Once your plantar fasciitis is treated and the pain resolves, the spur can remain without causing any problems. Many people live their entire lives with heel spurs and never experience symptoms.
Why do doctors order X-rays if the spur isn’t the problem?
X-rays help rule out other potential causes of heel pain, such as stress fractures, bone tumours, or arthritis. While the X-ray might show a heel spur, the real value is in confirming there aren’t other structural issues causing your symptoms. Our podiatrists diagnose plantar fasciitis primarily through clinical examination, not just imaging.
Will my heel pain come back after treatment?
Plantar fasciitis can recur if you return to the activities or habits that caused it initially. However, most people who complete their treatment programme and maintain good footwear habits, regular stretching, and appropriate activity levels don’t experience a recurrence. If you have underlying biomechanical issues, continuing to wear supportive orthotics can help prevent future episodes.
If you’re struggling with heel pain and want clarity on what’s actually causing it, our team at Happy Feet Podiatry can provide a thorough assessment and evidence-based treatment plan. We’ll look beyond the X-ray report to identify and address the real source of your discomfort. Book an appointment today to get your heel pain sorted properly.
⚕️ Medical Disclaimer
This article is for general information purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. The information provided should not be used to self-diagnose or self-treat any health condition. Always consult a registered podiatrist or qualified healthcare professional before starting any treatment.
If you’re experiencing foot or lower limb pain, the team at Happy Feet Podiatry is here to help. Book an appointment today for a personalised assessment and treatment plan.