“The X-ray showed a spur”: what that actually means
Heel spurs form slowly, over months and years, as the body responds to sustained pulling where soft tissue anchors to the heel bone. Think of it as a stress response set in bone, a record of tension, like a tree root thickening where the wind loads it. Two facts reframe everything:
- Plenty of pain-free people have spurs. Roughly one in ten adults has a heel spur on X-ray; only a fraction have heel pain. Spurs are frequently discovered by accident on images taken for something else entirely.
- Plenty of people with severe heel pain have no spur at all. The pain generator is usually plantar fasciitis, inflammation and micro-tearing of the fascia, whether or not a spur happens to be present.
So when a patient arrives saying “I need this spur removed,” our first job is gentle myth-busting: treat the inflamed tissue and the mechanics behind it, and the pain resolves in the great majority of cases, with the spur still sitting there, harmless, on future X-rays.
Two kinds of heel spurs, two different stories
- Plantar heel spurs (under the heel): companions of plantar fasciitis. Pain is classically sharpest with the first steps of the morning and after long standing, a pattern that points to the fascia, not the bone.
- Posterior heel spurs (back of the heel): companions of Achilles tendon problems, often alongside a tender bump that shoe backs rub against. These are managed through the Achilles side of the equation.
How we treat heel spur pain at Mountain Vista Foot & Ankle
Because the pain is soft-tissue pain, treatment targets the soft tissue and the forces overloading it:
- Accurate diagnosis: exam plus imaging when indicated, distinguishing fascia, tendon, nerve, stress fracture, and joint sources of heel pain (they’re all treated differently)
- Offloading the pull: custom orthotics, heel cushioning, taping, and footwear strategy
- Stretching and strengthening for the calf and fascia: the tension the spur was built by is the tension we reduce
- Anti-inflammatory care and targeted injections for stubborn inflammation
- Advanced options for the rare chronic case, and honest counsel that spur removal surgery is uncommon, reserved for select situations (more often posterior spurs interfering with the Achilles) after conservative care has truly been exhausted
If you’ve been told (by a friend, a forum, or an old X-ray report) that you’ll “need surgery to get the spur out,” come get a second look. The odds are strongly in your favor.
Frequently asked questions
Do heel spurs need to be surgically removed?
Rarely. Because the spur usually isn’t the pain source, treating the inflamed fascia or tendon resolves most cases. Surgery is a last resort for select chronic situations, most often at the back of the heel.
What’s the difference between a heel spur and plantar fasciitis?
Plantar fasciitis is the painful inflammation; a heel spur is a bony deposit that often forms alongside it. You can have either without the other, and it’s the fasciitis that hurts.
Will a heel spur go away on its own?
The bony spur typically stays, but that’s fine, because it isn’t the problem. The pain resolves with proper treatment in the great majority of patients.
Why does my heel hurt most with the first steps in the morning?
That’s the fascia’s signature: it tightens overnight, then stretches abruptly when you stand. Morning-step pain points to plantar fasciitis as the true diagnosis, spur or no spur.
How is a posterior (back-of-heel) spur treated?
Through the Achilles: heel lifts, footwear that doesn’t press the bump, calf work, and load management. Surgical spur removal is considered only when the spur mechanically interferes with the tendon despite thorough conservative care.
Stop blaming the spur, and start fixing the pain. Call Safford: (928) 348-3700 or Sierra Vista: (520) 515-FOOT (3668), or request an appointment. New patients welcome; most insurance accepted.