Heel Spurs: Causes and PT-Approved Exercises for Pain Relief

The word spur may make you think of something pointy or painful. But heel spurs are actually fairly common, and often don’t cause any symptoms, says Mary Kimbrough, PT, DPT, a physical therapist at Hinge Health. 

Even more reassuring, if you do experience some discomfort, heel spurs don’t have to disappear for you to feel better. “If your heel spur causes you pain, you can treat it with simple, at-home measures like foot strengthening and stretching exercises, ice or heat, and even physical therapy,” Dr. Kimbrough says.

Read on to learn more about heel spurs — what they are, what causes them, how to treat them, especially with exercises recommended by our Hinge Health physical therapists. You’ll feel better on your feet in no time. 

What Is a Heel Spur?

A heel spur occurs when extra bone forms on the heel bone. It’s common in people who have chronic plantar fasciitis (when the band of tissue that runs along the bottom of your foot and supports your foot arch becomes inflamed) or Achilles tendinitis (irritation of the fibers that form the Achilles tendon). 

Heel spurs are very common. One study found them in about 12 percent of people who complain of foot and heel pain. But the actual number may be even higher. “You can have a heel spur without any symptoms at all,” points out Dr. Kimbrough. They tend to develop gradually, over time. They’re harmless and don’t need to be treated unless they bother you.

Symptoms of a Heel Spur

Heel spurs don’t always cause discomfort. But some heel spur symptoms can include:

• Pain, usually at the bottom of the foot near the heel.

• Swelling around the heel.

• Pain that’s worse with the first few steps after you get out of bed in the morning, or get up from sitting for a prolonged period of time.

• Pain that worsens after (not during) activity.

Causes of Heel Spurs

You develop a heel spur when calcium builds up on the underside or backside of your heel bone. “It’s your body’s way of trying to protect you from the load and stress that you are placing on your heel,” explains Dr. Kimbrough.

Anyone can develop a heel spur, but there are a few things that make you more likely to experience one. They include:

• Ramping up workouts too quickly. If you’re used to running 5Ks and you suddenly plunge into marathon training, for example, your body may go on the defensive and begin creating heel spurs as a protective measure.

• Standing for long periods of time. If you have an occupation where you need to be on your feet a lot (like nursing, teaching, or working in a restaurant or factory), the constant pressure can put strain on your feet, especially if you are not wearing supportive shoes. This doesn’t mean you should avoid standing, but you can make small changes to make it more comfortable for your feet and your entire body.

• Your foot anatomy. Both flat feet or a high arch can make heel spurs more likely.

• Tight calf muscles. A 2021 study in the journal Foot & Ankle International found that tight calf muscles contribute to heel pain by causing tension in the plantar fascia, which puts more stress on the heel.

• Age. Research shows that heel spurs are more likely the older you get, with most occurring among people between the ages of 40 and 60. One reason may be that there are natural, age-related changes to the fat pads in your heels, which may increase pressure on your heels.

While you can’t control all the factors that contribute to a heel spur, there’s still a lot you can do to keep your heels healthy and manage any symptoms that arise — especially with exercise.

Treatment Options for Heel Spurs

Heel spurs won’t go away on their own, but you don’t need them to go away for you to get better. Most of the time, heel spur symptoms can be treated and managed with conservative measures and become less bothersome over time. Hinge Health physical therapists recommend the following for heel spur treatment.

• Modify activities. While complete rest isn’t recommended, you may need to stop any activities that make your heel pain worse, like running or jumping, for a short period of time. It’s important to stay active, though, to increase blood flow to the area, says Dr. Kimbrough. Low-impact activities like biking, walking, or swimming are all good ideas. You should also do exercises to stretch and strengthen the area, like the ones suggested below. “Stretching is especially important, because heel spurs can be aggravated by tight muscles in your feet and calves,” explains Dr. Kimbrough.

• Ice or heat. Ice is best for the first few days after the onset of heel spur symptoms, since it can help to reduce inflammation, says Dr. Kimbrough. One good option is to roll your heel over an ice-cold water bottle for 10 to 15 minutes three to four times a day. After about 48-72 hours, you may prefer heat, but both ice and heat can relieve symptoms so go with whichever feels best to you.

• Over-the-counter (OTC) medication. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can be helpful for heel spur pain. It’s important to make sure that you are safely able to take these medications, based on your medical history.

• Physical therapy. If pain persists for more than a couple weeks, a physical therapist can design an exercise program to stretch and strengthen the muscles surrounding your injured heel. They can also show you ways to modify day-to-day activities so that you can do them without pain. You can see a physical therapist in person or use a program like Hinge Health to access a PT via telehealth/video visit.

• Supportive shoes. While there’s no perfect shoe that works for everyone, if you have a heel spur, you may find it helpful to wear shoes with thick soles and extra cushioning to provide more support for your heels when you stand and walk. “Some people have very flexible feet, which puts a lot of stress on their heel when they walk or run,” points out Dr. Kimbrough. In these cases, shoe inserts can support and even lift up your foot arch, to reduce irritation of the soft tissue in your heel and foot that can contribute to heel spurs. “It also helps to distribute load across your foot more evenly,” adds Dr. Kimbrough.

• Night splints. Heel spur pain can be worse in the morning, since many of us tend to sleep with our toes slightly pointed, which causes calves to tighten overnight, says Dr. Kimbrough. A night splint can help to stretch your calves while you sleep.

• Taping. This also helps to relieve heel spur pain, especially if you have flat feet. “It lifts your foot and ankle up to support your arch and takes pressure off your heel,” explains Dr. Kimbrough. A physical therapist can show you a taping technique that you can do on your own.

If you’ve tried all these measures for a few weeks and they don’t provide enough symptom relief, Dr. Kimbrough recommends that you see a doctor. They can do an X-ray to determine whether a heel spur is causing your pain or if it’s another issue, and suggest treatment accordingly.