Heel Pain & Heel Spurs

What Causes Heel Pain?

The heel bone (calcaneus) is the largest bone in the foot and absorbs tremendous force with every step. Heel pain can stem from several sources, and an accurate diagnosis is essential to choosing the right treatment.

• Heel spurs — bony growths that form on the underside of the heel bone, often as a result of chronic plantar fasciitis or repeated strain on the foot's connective tissue
• Plantar fasciitis — inflammation of the band of tissue connecting the heel to the toes; the most common cause of heel pain (see our Plantar Fasciitis page)
• Achilles tendinitis — irritation of the tendon that attaches the calf muscle to the heel
• Bursitis — inflammation of the fluid-filled sac (bursa) at the back of the heel
• Stress fractures — tiny cracks in the heel bone from repetitive impact, common in runners and athletes
• Poor footwear — shoes lacking adequate arch support or cushioning force the heel to absorb more impact than it should

Symptoms

Heel pain most commonly presents as a sharp or stabbing sensation on the bottom or back of the heel. Classic warning signs include:

• Intense pain with your first steps in the morning or after sitting for a long period
• Pain that eases after a few minutes of walking, then returns after prolonged activity
• Tenderness when pressing on the heel or arch
• Swelling or redness around the heel
• A dull ache at the back of the heel that worsens after exercise

Diagnosis

Dr. Ross will perform a thorough physical examination and take a complete history of your symptoms. X-rays are typically obtained to evaluate for bone spurs, fractures, or alignment issues. In some cases, advanced imaging such as an MRI or ultrasound may be ordered to assess soft tissue structures.

Treatment Options

The vast majority of heel pain cases resolve with conservative (non-surgical) treatment. Dr. Ross's approach is always to exhaust non-surgical options before considering any procedure.

Non-Surgical Treatments

• Custom orthotics — fabricated in our own lab, orthotics redistribute pressure away from the inflamed area and correct the underlying mechanical cause
• Night splints — keep the foot in a stretched position overnight so the plantar fascia heals at full length
• Physical therapy — targeted stretching and strengthening of the calf, Achilles tendon, and plantar fascia
• Corticosteroid injections — reduce localized inflammation when conservative measures haven't provided sufficient relief
• Appropriate footwear — shoes with cushioned heels and solid arch support are often the single most impactful change a patient can make
• Ice and rest — reducing activity and applying ice for 15–20 minutes several times daily helps control acute inflammation
• Anti-inflammatory medication — oral NSAIDs can reduce pain and swelling in the short term

When Is Surgery Considered?

Surgery is reserved for cases where 6–12 months of consistent conservative treatment have failed to provide adequate relief. Procedures may include removal of a heel spur (calcaneal exostectomy) or a plantar fascia release. Dr. Ross will always discuss all options with you transparently before recommending any surgical approach.