Heel Spurs: What They Are, Why They Happen, and How to Treat Them

Heel pain is one of the most common foot complaints we see at the Bowman Physical Therapy clinics, and many patients are told they have a heel spur after an X-ray. While the name can sound alarming, heel spurs are very common—and very manageable, especially with the right treatment plan.

Let’s break down what a heel spur is, what causes it, what it feels like, and how physical therapy can help you get back to pain-free movement!

What Is a Heel Spur?

A heel spur is a bony outgrowth (osteophyte) that forms on the calcaneus, or heel bone. It develops gradually as calcium builds up at the point where soft tissues—most commonly the plantar fascia—attach to the heel.

Heel spurs are often visible on X-ray and may appear as a small hook- or shelf-like projection from the heel bone. Importantly, many people have heel spurs and experience no pain at all.

In most cases, the pain people feel is not caused by the spur itself, but by irritation or inflammation of the surrounding soft tissues.

What Causes Heel Spurs?

Heel spurs develop over time due to repetitive stress and traction placed on the heel bone. This ongoing pulling stimulates the body to lay down extra bone at the attachment site.

Common contributing factors include:

• Plantar fasciitis (chronic irritation of the plantar fascia)

• Tight calf muscles or Achilles tendon, which increase tension on the heel

• Prolonged standing or walking, especially on hard surfaces

• High-impact activities such as running or jumping

• Poor footwear with inadequate arch or heel support

• Foot mechanics, such as flat feet or very high arches

• Increased body weight, which raises load through the heel

Heel spurs are often found alongside plantar fasciitis, but the two are not the same condition.

What Does a Heel Spur Feel Like?

Symptoms vary widely. Some people never feel their heel spur, while others experience persistent discomfort.

Common symptoms include:

• Sharp or stabbing pain in the heel, especially with the first steps in the morning

• Deep aching pain after long periods of standing or walking

• Tenderness at the bottom of the heel

• Pain that improves with movement but worsens again later in the day

Morning pain happens because the plantar fascia tightens overnight, and sudden tension is placed on the heel when you first stand up.

How Physical Therapy Helps Heel Spurs

Physical therapy is one of the most effective, evidence-based treatments for heel spur–related pain. Rather than focusing on the bone itself, physical therapy addresses the mechanical causes that led to the problem.

In physical therapy, treatment may include:

- Targeted stretching

• Calf muscles

• Achilles tendon

• Plantar fascia (Reducing tightness decreases pulling on the heel bone)

- Strengthening exercises

• Foot intrinsic muscles

• Ankle stabilizers

• Hip and lower-extremity muscles (This improves shock absorption and foot mechanics during walking)

- Manual therapy

• Soft tissue mobilization / myofascial release

• Dry needling (Helps increase blood flow, reduce inflammation, and speed up healing)

• Joint mobilization (Helps restore mobility and reduce tissue irritation)

- Gait and movement retraining

• Addressing walking and standing mechanics that overload the heel

- Footwear and orthotic guidance

• Education on supportive shoes

• Temporary orthotics if appropriate

WIt our patients here at Bowman Physical Therapy, the goal is not just pain relief—but long-term prevention.

The good news is, surgery to remove a heel spur is rarely needed and is typically only considered after many months of unsuccessful conservative care.

How to Manage Heel Spurs at Home

In addition to physical therapy, several at-home strategies can help manage symptoms:

• Stretch daily, especially calves and the bottom of the foot

• Wear supportive shoes—avoid flat sandals or worn-out sneakers

• Limit barefoot walking, especially on hard floors

• Ice the heel for 10–15 minutes if pain flares

• Gradually modify activity, rather than pushing through pain

• Use a night splint if recommended to reduce morning pain

Consistency is key—small daily habits make a big difference.

The Bottom Line

Heel spurs are common and often misunderstood. While they may sound intimidating, they are usually a sign of long-term stress on the foot, not a serious bone problem. With the right combination of physical therapy, movement correction, and supportive habits, most people experience significant relief without injections or surgery.

If heel pain is limiting your daily life, addressing the root cause early can help you stay active and pain-free for the long run.

Are you struggling with heel or foot pain? Give one of our three Bowman Physical Therapy clinic locations a call today to schedule an appointment and find relief, or request an appointment here on our website: 

Oakbend Physical Therapy of River Oaks: 832-409-6390

Oakbend Physical Therapy of Upper Heights: 346-571-6381

Oakbend Physical Therapy of Friendswood: 281-482-7380