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St. Mary's Center for Orthopaedics

Heel Spurs and Bone Spurs

Heel spurs (calcaneal spurs) are protrusions (bumps) on the forward underside of the heel bone that can occur when the plantar tendon pulls excessively in the area where it attaches to the bone. The condition is often associated with plantar fasciitis, although it can also occur on its own. Heel spurs typically are not painful unless they intrude into the soft tissue (plantar fascia), where they can cause irritation that results in heel pain.

Bone spurs (retrocalcaneal spur, or exostosis) can develop not only on the back of the heel, but also on the toes, mainly around the fifth (small) toe. Most often, they occur next to the toenail on the outside of the toe; on the inside of the toe near the tip, where the fifth toe presses against the fourth toe; and on the inside of the base of the toe.

Bone spurs can also occur on the sides of the toes. This is usually due to wearing shoes that are too tight in the toe box, which causes the toes to press against each other. Bone spurs may also develop in the arch area of the top of the foot; this area becomes painful when you tie your shoelaces tightly or exert other pressure on that part of the foot. Formation of spurs in this area is often associated with arthritis.

What Causes Bone Spurs?

Bone and/or heel spurs may be caused by the following:

  • Unusual or abnormal motion in the joints over time
  • Excessive tension on the bone from a tendon
  • Trauma–both severe and repetitive (everyday “wear and tear”)
  • The aging process
  • Conditions such as osteomyelitis (bone infection) and Charcot foot
  • General inflammation

Who is Susceptible to Heel Spurs?

Heel spurs are a common condition in people who have a history of chronic foot pain due to plantar fasciitis. Plantar fasciitis is most commonly seen in middle-aged women and men, but may be seen in all ages.

The actual heel spur does not cause the pain, rather the irritation and inflammation of the tissue around the heel is the primary source of pain.

Bone Spur Diagnosis

A bone spur can usually be seen by X-ray. However, since many bones spurs are not problematic, you would probably only find out about the condition if it were causing pain. If an x-ray were preformed to evaluate one of the many problems associated with heel spurs, like arthritis, the spurs would be seen on that x-ray.

Heel Bone Spur Symptoms

Many people develop bone spurs without even knowing it. This is because many bone spurs occur without symptoms. However, if the spur is pressing on tissues or other bones or is causing a tendon or muscle to rub, that tissue may break down over time, causing tearing, swelling, and pain. Bone spurs can also result in calluses and corns to help cushion the bone spur.

Prevention and Treatment

As stated earlier, bone spur formations are not always caused by external forces and may also be attributed to age and other internal factors. Having stated that, there are things you can do to help prevent bone spurs and heel spurs.

  • Try wearing more comfortable shoes if you wear tight or constricting shoes such as high heels
  • If you are unable to wear comfortable shoes all the time, try to wear them as often as possible
  • Try shoe inserts to help alleviate pressure to the heel
  • Consult a podiatrist to see if you may be prone to heel spur development