A heel spur is a calcium deposit that creates a bony-like growth on the underside of the heel, or underneath the sole of the foot. These growths are caused by excessive strain, friction, or pressure on the heel bone.
Factors that contribute to heel spurs include:
- exercise (running, walking, or jogging)
- wearing poor-fitting shoes or high heels
- having flat feet or a high arch
You’re also at risk of developing a heel spur if you’re overweight or have arthritis.
Some heel spurs are painless and go unnoticed. If you have pain, it can be intermittent or chronic. Surgery is one option to alleviate pain associated with a heel spur. But this is not the first line of defense.
A doctor will first recommend other treatment methods to resolve pain. Most people who have a heel spur don’t need surgery. In fact, “more than 90 percent of people with heel spurs get better with nonsurgical treatments,” according to the Cleveland Clinic.
Nonsurgical recommendations include:
- stretching exercises
- shoe inserts
- physical therapy
- nighttime ankle splints
Over-the-counter medications like acetaminophen and ibuprofen can also relieve pain and inflammation. In addition, a doctor can administer a cortisone injection in your heel to reduce inflammation.
If you take these measures without good results, your doctor may recommend 1 of 2 surgical procedures as a last resort, but only after 12 months of nonsurgical therapy.
Two surgical options are available for heel spur pain.
Release of the plantar fascia
Heel spurs can sometimes occur with plantar fasciitis. This is inflammation of the plantar fascia, which is the fibrous tissue that connects your toes to your heel bone.
Putting too much strain on the plantar fascia can cause a heel spur to form. About 50 percent of people with plantar fasciitis have a heel spur. The pain they feel in their foot, however, doesn’t always come from this bony growth. It often comes from inflammation of the plantar fascia.
To relieve pain, a doctor may perform a surgical procedure called plantar fascia release. This involves cutting a part of the planter fascia ligament to relieve tension and inflammation in the tissue. This is an outpatient procedure performed as an open surgery or an endoscopic surgery.
With an open surgery (or traditional surgery), your surgeon cuts the area with a scalpel and completes the procedure through a large incision. Endoscopic surgery, on the other hand, is minimally invasive.
This involves cutting one or more smaller incisions, and then inserting small surgical tools through the opening to perform the surgery.
Removal of the heel spur
During plantar fascia release surgery, your surgeon may opt to completely remove the heel spur. Heel spur removal surgery doesn’t happen in every case. In fact, these surgical procedures are rare today, according to the Mayo Clinic. Even so, it’s an option for a painful or larger spur that you can feel underneath the skin.
This procedure is also completed with either an open surgery or an endoscopic surgery. Your surgeon makes one large incision or a couple of smaller incisions, and then uses surgical instruments to remove or detach the bony calcium deposit.
You’ll wear a bandage for one to two weeks after surgery, and possibly a cast, walking boot, or ankle splint for up to three weeks after an open surgery. You may also receive crutches or a cane. The surgical area will be swollen and painful, so you’ll need to stay off your feet for at least a few days.
Putting too much weight on your heel after surgery can delay healing. Be prepared to follow up with your surgeon within a couple of weeks after surgery. At this point, you should be able to put weight on your heel.
Typically, it can take up to six weeks to recover from plantar fascia release surgery, and up to three months to recover from heel spur removal surgery. The amount of time you’ll take off from work varies depending on how much time you spend on your feet.
A person with sedentary employment might only need a couple of weeks off. If your job involves a lot of standing or walking, you may need to take four weeks off. Talk to your doctor for advice on when to return to work.
Also, make sure you follow your doctor’s post-surgery recommendations for a speedy recovery. For example:
- Take over-the-counter or prescription pain medication as directed.
- Apply cold compresses to the surgical area.
- Keep your foot elevated.
- Limit movement and walking in the days following your procedure.
There’s the risk of complications with any type of surgical procedure. Heel surgery complications include:
- increased blood loss
- nerve damage
- permanent numbness
Complications can happen to anyone, but certain factors may increase your risk, including:
- advanced age
- a bleeding disorder history
- taking blood-thinning medication
- poor immune system
- history of an autoimmune disease
Contact your doctor immediately if you experience any problems after surgery. This includes:
- increased pain around the surgical site
- severe swelling and redness
- bleeding or discharge from the wound
- signs of an infection, such as a high fever
Heel spur removal surgery isn’t recommended for a heel spur that has recently started to cause pain. In most cases, you’ll see an improvement in pain within a few months of beginning nonsurgical treatments.
You may be a candidate for surgery if your heel spur is large, or if heel pain doesn’t improve or worsens after 12 months of other treatment.
The cost of heel spur surgery varies depending on the type of procedure (plantar fascia release or complete heel spur removal). The cost also varies by location and hospital.
Heel surgery is typically covered by health insurance. The amount you’re responsible for is based on your provider. Keep in mind that many policies require patients to pay a deductible. You must spend this amount out-of-pocket before your insurance pays for covered services. You may also be responsible for coinsurance and copays.
Speak with your health insurance provider to get an estimate of your expected out-of-pocket expenses.
Heel spur surgery is successful for some people, but it doesn’t work for everyone. While some people begin to see an improvement in pain and discomfort in about a week after surgery, others continue to have persistent pain following their procedure.
Even when surgery is successful, a heel spur can return. This is possible when factors contributing to the original spur development continue. To prevent future heel spurs, wear properly fitting shoes and the right type of shoes for activities. For example, wear running shoes if you’re a runner.
Adding insoles or extra padding to the inside of shoes can also relieve pressure and strain. It also helps to stretch daily and maintain a healthy body weight.
Heel pain that doesn’t go away can decrease mobility and make it difficult to walk, stand, or exercise. See a doctor for any heel discomfort. Heel spur pain will likely go away after a few months, but if not, surgery might help you get back on your feet.