Do you have pain under your heel and wonder if it could be a heel spur? Many people describe a sharp or stabbing sensation when their foot hits the ground after resting. The pain may be most noticeable with the first steps in the morning or when you begin to walk after sitting still for a long time.
If you want to read more about symptoms and underlying causes, we recommend our Injury Guide on Heel Spurs.
Common signs of heel spurs
- pain under or on the inside of the heel
- severe pain with the first steps in the morning
- pain that decreases after you have walked for a while but returns with prolonged exertion
- tenderness when you press just in front of the heel bone
This pattern is typical of overuse of the plantar fascia, a wide band of connective tissue that runs under the foot.
The term heel spur is often used as a collective term for pain at the attachment of the plantar fascia to the heel bone. An X-ray can sometimes show a small bony protrusion. However, you can have such a bony protrusion without it causing any direct symptoms. The pain you feel comes primarily from the tendon attachment.
The discomfort often occurs after overload, for example, with increased walking or running, or if the shoes provide insufficient support and cushioning. In many cases, the pain subsides over time, especially if the load is adjusted and the foot is relieved.
This is what a heel spur feels like in everyday life
The pain is usually located under the heel or slightly on the inside of it and can sometimes extend towards the ball of the foot. A typical characteristic is that the first steps in the morning hurt the most, but that the pain decreases after you have walked for a while.
The same thing can happen after sitting still for a long time. However, after longer walks, a lot of standing work, or running, the pain can come back and feel more like a dull or burning ache.
If you press on the underside of the heel on the inside and just in front of the heel cushion itself, it is often clearly tender.
Heel spur or something else?
Several different conditions can cause pain under the heel, and the symptoms can sometimes be similar. Some common clues include:
Heel spur/plantar fasciitis
The pain is often located at the attachment of the plantar fascia to the heel bone under the heel and is most evident with the first steps in the morning or after rest.
Trampled/irritated fat pad in the heel
The pain is felt more in the middle of the heel, often as a bump or bruise-like sensation with each impact.
Sever's injury
In children who play sports and have heel pain, it may be the growth plate in the heel bone that is overloaded and causing pain. Pain during exertion is common, especially during sports and barefoot activities.
Other causes
Radiating pain, numbness, or aching that does not respond to exertion may indicate another cause and should be assessed by a healthcare professional.
In typical cases, an X-ray is rarely needed. A physiotherapist can often assess the problem by considering the location of the pain, load patterns, and how the foot reacts to different movements.
Why do the problems occur?
The most common cause of heel spurs is overuse of the plantar fascia, the strong band of connective tissue that helps the arch of the foot maintain its shape.
The load can increase, for example, when:
- rapid increase in walking or running
- a lot of standing work on hard floors
- shoes with poor shock absorption or a lack of arch support
Often, several factors together contribute to the occurrence of the problem.
The fact that the pain often decreases once you start walking is likely due to the tissue warming up and becoming more resistant to strain. However, when the strain is prolonged, the irritation can increase again.
Self-care that often relieves
The first step is often to reduce or pause activities that clearly trigger the pain, such as running or long walks, until everyday steps feel more comfortable again.
Meanwhile, other activities like cycling or swimming may work better because they put less strain on the foot.
It may also help to:
- wear shoes with good shock absorption and stable soles
- insert shock-absorbing soles or cushioning inserts
- use a heel cup that reduces pressure on the heel
Physiotherapy with gradually increasing exercises for the arch and calf muscles can help make the tissue more resistant to stress. Stretching and taping are sometimes used to temporarily reduce the tension in the plantar fascia.
In the case of more long-term problems, treatment such as shockwave therapy or individually adapted shoe inserts may be considered.
See our products for heel spurs
If you want to understand more about symptoms, causes, treatment, and when it may be wise to seek care, we recommend our Injury Guide on Heel Spurs.
If you would like help choosing the right product based on your complaints, you are always welcome to contact our physiotherapist.
