Heel Spurs

A heel spur is a calcium deposit — a small bony projection — that forms on the underside of the heel bone, most commonly at the point where the plantar fascia attaches to the calcaneus. Heel spurs develop gradually over time in response to chronic tension and pulling at the fascia-bone junction. They are visible on X-ray and are frequently identified when a patient presents with heel pain.

Here is the most important clinical fact about heel spurs: the spur itself is rarely the source of the pain.

Studies consistently show that a significant percentage of adults have heel spurs on X-ray with no pain whatsoever — and many patients with significant heel pain have no spur at all. The presence of a heel spur on imaging does not confirm the spur is causing the pain. What typically causes the pain is the inflamed and irritated plantar fascia — the thick band of tissue that runs along the bottom of the foot from the heel to the toes. The spur forms because that tissue has been chronically stressed, but it is the tissue inflammation, not the calcium deposit, that produces the sharp, stabbing heel pain patients experience.

This distinction matters enormously. Patients who focus on removing the spur are often pursuing a solution to a problem that is not the actual source of their pain. The spur is an X-ray finding — a historical record of chronic stress at the heel. The pain is a soft tissue problem that requires soft tissue evaluation and management.

That said, a heel spur found on X-ray is a meaningful clinical finding. Its presence confirms the heel has been under chronic mechanical stress — which is exactly the kind of biomechanical information Dr. Gunter incorporates into a comprehensive evaluation. Understanding why that stress developed, what structures are involved, and how the foot's mechanics are contributing to the problem is the work of a proper clinical assessment — and it is what produces lasting relief rather than temporary management.