Heel spurs are a common cause of sharp heel pain under the heel, especially with the first steps in the morning. They often occur with plantar fasciitis and can affect walking, work and sport. Our Brisbane physiotherapists regularly treat heel spurs and plantar heel pain using hands-on care, exercise and practical advice.

What Are Heel Spurs?

Heel spurs, or calcaneal spurs, are small bony growths on the underside of the heel bone. They form where the plantar fascia and surrounding soft tissues attach into the heel. On X-ray they look like a small hook or spike projecting forwards from the heel bone.

Many people have heel spurs without any pain. When symptoms occur, the pain usually comes from irritated soft tissues such as the plantar fascia rather than from the bony spur itself. This is why treatment focuses on plantar heel pain and biomechanics, not just the spur on the scan.

What Causes Heel Spurs?

Heel spurs usually develop after long-term overload of the plantar fascia and surrounding soft tissues. Repeated stress at the heel attachment can trigger extra bone formation over time.

Common contributors include:

• Sudden increases in walking, running or standing time
• Hard surfaces and unsupportive or worn-out footwear
• Foot posture issues such as flat feet or high arches
• Tight calf muscles and reduced ankle mobility
• Higher body weight or pregnancy increasing load on the heel
• Jobs that involve long hours on your feet
• Conditions such as arthritis or diabetes that affect tissue health

Heel Spur Symptoms

Heel spur pain can range from a mild ache to sharp, stabbing pain under the heel. Typical symptoms include:

• Sharp pain under the heel with the first steps in the morning
• Heel pain after sitting, especially when you stand up and walk
• Pain that eases as you warm up, then returns with prolonged activity
• Tenderness when you press on the underside of the heel
• Discomfort when walking barefoot on hard floors

Children and teenagers with heel pain may have a different condition called Sever’s disease rather than a heel spur. Your physiotherapist can assess this.

How Are Heel Spurs Diagnosed?

Your physiotherapist will begin with a detailed history and physical examination. They will assess foot posture, calf and foot flexibility, gait, footwear and any training or workload changes. They will also check for other heel pain conditions and foot pain conditions that can mimic heel spurs.

In many cases, imaging is not required at first. If symptoms persist or another diagnosis is suspected, your doctor may organise an X-ray, ultrasound or MRI. These scans can show a calcaneal spur, plantar fascia changes and other structures such as bursae or the Achilles tendon.

It is common for scans to show heel spurs in people without pain. For this reason, your symptoms and clinical examination are more important than the size of the spur alone.

Physiotherapy Treatment for Heel Spurs

Most people improve with a structured physiotherapy program. Treatment aims to reduce pain, improve tissue tolerance and optimise how your foot and leg move.

Short-Term Pain Relief

• Activity modification to reduce aggravating loads while you recover
• Ice or cold packs after activity to settle irritation
• Gentle soft tissue therapy and joint mobilisation to improve comfort
• Temporary heel cushions or gel cups to offload the sore area

Stretching and Exercise

Targeted stretching and strengthening are key elements of heel spur treatment. Your physiotherapist may prescribe:

• Plantar fascia-specific stretches and calf stretches
• Strengthening of the foot intrinsic muscles and arch support muscles using active foot posture correction exercises
• Progressive calf strengthening to improve load tolerance
• Balance and functional exercises to support return to walking, work and sport

Taping, Bracing and Footwear

Mechanical support can reduce strain on the plantar fascia and heel.

• Low-dye and other taping techniques to support the arch and reduce pain
• Plantar fascia bracing or night splints to provide low-load stretch
• Advice on supportive shoes with adequate cushioning and heel support
• Custom or prefabricated orthotics where foot posture or workload require extra support

For more options, you can review our heel braces and supports range.

Adjunct Treatments

Your physiotherapist and doctor may discuss additional options if symptoms persist despite a good rehabilitation program. These may include:

• Extracorporeal shockwave therapy in selected cases of stubborn plantar heel pain
• Dry needling or acupuncture to help modulate pain
• Corticosteroid or other injections, which can provide short-term relief but may not be a long-term solution
• Referral to a surgeon for rare cases that fail to improve with comprehensive conservative care

Decisions about these options depend on your goals, medical history and response to earlier treatment.

How Long Does Heel Spur Pain Take to Settle?

Recovery time varies. Mild heel spur pain may settle within a few weeks once load and footwear improve. More persistent cases, particularly where pain has been present for many months, may take several months to fully resolve.

Most people improve steadily with consistent physiotherapy, home exercises and load management. Your physiotherapist will review your progress and adjust the plan as your symptoms change.

Preventing Heel Spur Pain Returning

Once your pain has settled, an ongoing prevention plan helps reduce flare-ups. This often includes:

• Maintaining calf and plantar fascia flexibility
• Continuing foot and leg strengthening exercises
• Choosing supportive everyday and sports footwear
• Gradually building walking or running loads rather than making big jumps
• Monitoring weight, general health and other joint or tendon issues

When Should You See a Physiotherapist?

Book a physiotherapy assessment if:

• Heel pain lasts longer than a couple of weeks
• Pain keeps returning when you try to increase walking, running or sport
• Morning steps are very painful or you are limping
• You are unsure whether the pain is from heel spurs, plantar fasciitis or another condition

Early treatment can shorten recovery time, reduce the risk of chronic pain and help you stay active.

You can book at your nearest PhysioWorks clinic for a detailed heel assessment and treatment plan.

Heel Spur FAQs

Are heel spurs always painful?

No. Many people have heel spurs on X-ray without any pain. When symptoms do occur, they usually relate to irritated soft tissues such as the plantar fascia rather than the spur itself.

Do heel spurs go away?

The bony spur usually remains on X-ray, but your pain can settle completely. Treatment targets pain and function rather than trying to dissolve the spur.

Can I keep walking with heel spurs?

In most cases you can keep walking, but you may need to reduce distance, change footwear and add support while treatment starts. Your physiotherapist will guide safe activity levels for you.

Will I need surgery for heel spurs?

Surgery is rarely required. Most people respond well to physiotherapy, load management, footwear advice and, when needed, orthoses or other adjuncts. Surgery is usually reserved for stubborn cases that have not improved over many months of good conservative care.

What is the best treatment for heel spurs?

The best treatment combines stretching, strengthening, mechanical support and education tailored to your goals. A physiotherapist can coordinate this and work with your doctor or podiatrist if extra options are needed.

Related Articles

1. Plantar Fasciitis – Learn how plantar fasciitis develops, how it links with heel spurs, and the best treatment options.
2. Retrocalcaneal Bursitis – Discover how inflammation behind the heel bone can cause pain and how physiotherapy can help.
3. Achilles Tendinopathy – Find out how Achilles tendon irritation contributes to heel pain and how to manage it.
4. Foot Orthotics – See how custom and prefabricated orthotics can offload your heel and support your arch.
5. Stretching Exercises for the Foot and Heel – Practical stretches to ease heel tension and support recovery.
6. Heel, Foot and Ankle Pain FAQs – Common questions and answers about heel, foot and ankle pain.
7. Heel Pain in Children – Information for parents about Sever’s disease and children’s heel pain.

For general government-backed advice you can also review the Australian government’s Healthdirect heel pain advice.

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