Author: Chloe Wilson - BSc(Hons) Physiotherapy
Foot and heel bone spurs are areas where excess bone has grown forming a small lump which sticks out. They usually develop in response to irritation of the bone from inflammation, repetitive friction or stress, or following an injury.
The medical term for bone spurs is osteophytes. The most common type are calcaneal spurs, found either on the back or the base of the heel bone.
Bone spurs themselves are not painful or dangerous but if they start encroaching on neighbouring structures like muscles, tendons, nerves or other bones, they can cause pain, stiffness and numbness. Women have a much higher incidence of this problem due to the types of footwear they frequently wear such as shoes with high heels or pointed toes.
Here, we will look at the common causes, locations and symptoms of foot and heel bone spurs. We will then go on to look at the different treatment options.
Bone spurs develop when there is abnormal bone growth. When there is constant irritation or stress on a bone, the cells responsible for bone growth are stimulated to produce excess calcium deposits to try and protect the bone from injury. As the calcium deposit layers build up, a spur-shaped deformity forms. This can occur for a number of reasons:
1) Footwear: Wearing shoes that are too tight, unsupportive or the wrong shape place repetitive friction on parts of the foot. This commonly occurs on the back of heel
2) Injury: anything from minor bruising to a fracture of the bone can lead to the laying down of excess calcium deposits as part of the healing process. This is a good response to the problem, but if it continues too long, problems develop
3) Tension: Tightness in soft tissues such as ligaments, muscles and tendons is a common cause of heel bone spurs. The tight soft tissue pulls on the part of the bone that it is attached too, causing excessive tension and local inflammation.
4) Inflammation: When a joint is inflamed due to chronic conditions such as rheumatoid arthritis or ankylosing spondylitis the constant irritation can lead to bone spurs
5) Exercise: Repetitive activities such as running and jumping especially on hard surfaces can cause osteophyte problems
6) Abnormal Foot Biomechanics: A problem in the way the foot bones sit and move, such as reduced arch height, can place excess pressure on certain areas of bone leading to the formation of heel bone spurs
7) Ageing: As we age, the soft cartilage that lines our joints can start to degenerate. This places more pressure and friction through the bones which can lead to the formation of spurs. Bone spurs related to ageing are most commonly found in the spine or the feet
Excess bone can develop on any of the foot bones, but the most common place to get them is on the heel bone, the calcaneus. These are known as calcaneal spurs. They usually occur in one of two places:
Inferior Calcaneal Spur:
These are located underneath the heel bone. They usually develop in response to Plantar Fasciitis but can also be linked with ankylosing spondylitis or altered foot biomechanics. You usually can’t see or feel these heel bone spurs as they are surrounded by soft tissue until they are quite large.
2) Posterior Calcaneal Spur:
These develop on the back of the heel, usually due to Achilles Tendonitis, calf muscle tightness or ill-fitting shoes. You can usually see and feel a lump on the back of your heel. It may also end up irritating the local bursa (fluid filled sac), a condition known as "Pump Bump" or Haglunds Deformity.
Often, there are no obvious symptoms unless they start rubbing on the surrounding tissues, such as muscles, nerves or other bones. When this happens, there may be feelings of pain, stiffness and/or numbness, depending on what structure is affected. People often describe the pain as being a sharp or stabbing pain, like standing on a pin initially, then turning into a dull ache.
Pain tends to be worse after periods of rest, particularly first things in the morning or after sitting for long periods. The first few steps are often extremely painful, but the pain starts to subside after a while. It does however, often return if you are on your feet for long periods. The worst symptoms usually occur when the heel bone spurs start irritating the nearby nerves.
Another common symptom is the formation of corns and calluses over the affected area. This is the bodies attempt to try and cushion the spur from above.
Heel bone spurs are only treated if they are causing problems. If there is noticeable lump, but no pain or other symptoms, they will usually be left alone. If however they start to cause symptoms such as pain or numbness, or they are causing damage to surrounding structures, treatment is required.
Ninety percent of people with heel bone spurs will recover within six to nine months through a combination of exercises, orthotics and medication. The remaining 10% may require surgical intervention. You can find out all about the different treatment options in the Heel Spur Treatment section.
Alternatively, if this is not sounding quite like your problem, visit the foot pain diagnosis section for help working out what is wrong.