How Long Does a Heel Spur Last? (+ Tips)

A brief reminder of what a heel spur is

What is a heel spur concretely? It is a small bony outgrowth (calcaneal exostosis) that develops over time on the heel bone.

What are the symptoms of heel spur?

The symptoms of heel spur include:

• a sharp, stabbing pain in the heel,
• especially in the morning upon waking or after a period of inactivity, and in cold conditions,
• the pain can be aggravated by walking, running, jumping, or prolonged standing.

These symptoms are the same as those for plantar fasciitis. Therefore, the only way to diagnose plantar fasciitis with certainty is to use X-rays or other imaging techniques.

What is the location of a heel spur?

The heel spur is located on the heel bone: the calcaneus.

More precisely, it is situated where the plantar fascia (a band of tissue that connects the heel to the toes) inserts into this bone.

Difference between plantar fasciitis and heel spur

As I mentioned, the symptoms of plantar fasciitis are exactly the same as those of heel spur.

The difference can only be seen in imaging, which is often unnecessary because the management follows the same guidelines.

The anatomical structures affected are not the same:

🦴 It’s the bone in the case of plantar fasciitis;
➰ It’s a fascia (a type of fibrous tissue) for plantar fasciopathy.

Can you have a heel spur without plantar fasciitis?

Yes, you can have a heel without plantar fasciitis.

Why? Because some people may have a heel spur when an X-ray of the foot is taken… but actually have no pain, neither in the heel nor along the plantar fascia! In this case, it is referred to as asymptomatic heel spur.

On the other hand, if someone has:

• pain in the heel area;
• and a visible plantar fasciitis in the imaging;

it is often said in this case that they also have “plantar fasciitis” because it is not possible to be certain of the structure causing the pain: the fascia or the bony outgrowth?

How does a heel spur form?

The mechanisms behind the formation of a heel spur are not fully understood. A research team investigated this topic using studies on X-rays and tissues from human cadavers (Li, 2007).

The team found that:

• Heel spurs are generally not found in the traction path of the plantar fascia or plantar muscles.
• They are rather variably associated with soft tissues, including loose connective tissue, fibrocartilage, muscle, and the plantar fascia.
• The bony trabeculae of the spur are not aligned in the direction of soft tissue traction but rather in the direction of the stress exerted on the calcaneus during walking and standing.
• It is likely that the heel spur at the heel serves as a skeletal response to stress and may protect the bone against the development of microfractures.

A “problem” that might have a silver lining!

How do we know how long a heel spur lasts?

There are three ways to determine the average healing time of a heel spur:

1. Asking people you know around you how long it took for the pain to go away. As heel spurs are quite common (1 person in 10 will have one during their lifetime), you are likely to know one or more individuals who have experienced it.
2. Asking healthcare professionals (physiotherapists, doctors, pharmacists) for their opinion on the duration of recovery. Since they see many people with health issues, they may have a more precise idea due to a larger sample size.
3. Looking at statistics on the duration of recovery in studies that follow individuals with heel spurs over a long period.

Personally, I prefer to rely on the third option as it is the most reliable:

• It provides access to the largest number of individuals.
• It is the most methodical in collecting information and striving for reliability.

Therefore, in the rest of the article, I will rely on data from clinical studies, in addition to my own professional experience 🙂.

How long does a heel spur typically last?

There are more studies on the progression of plantar fasciitis than on the progression of heel spurs.

However, when research teams compare the progression time of people with only plantar fasciitis to those with plantar fasciitis + heel spur, they find that the progression time is not significantly different (Hansen 2028)!

In other words, the healing time of a heel spur is the same as the healing time of plantar fasciitis!

So here is how long a heel spur lasts according to the studies I have reviewed on the subject:

Study	Number of people Followed	Healing Time
Hansen 2018	174 over 5 to 15 years	▶️ 20% fully recovered 1 year after symptom onset
		▶️ 50% fully recovered 5 years after
		▶️ 45% fully recovered 10 years after
Wolgin 1994	100 people	▶️ 82% fully recovered 4 years after the start of medical follow-up
		▶️ 82% waited about 6 months of symptoms before consulting a healthcare professional
Buchanan 2020	?	▶️ 75% of individuals fully recovered within 1 year maximum
		▶️ It takes a few weeks to a few months to recover even with treatment
Shea 2002	?	▶️ Rarely improved in less than 8 weeks regardless of treatment
		▶️ 70% of patients saw improvement simply by regularly stretching, within 8 to 10 weeks
		▶️ 85 to 90% showed improvement within 6 months

These figures most often concern the total healing of plantar fasciitis, whether or not associated with a heel spur. This means the total disappearance of symptoms: pain, discomfort, inflammation, and bone growths objectified in imaging.

You may see a faster improvement in your symptoms. It is important to stay optimistic and tell yourself that these figures are the worst-case scenario. In fact, some physiotherapists or doctors have been able to see that some people recover much faster!

The healing time for a heel spur is a few weeks to a few months. Between 20 and 75% of people have no more symptoms after a maximum of one year. However, the symptoms can decrease or disappear in a few weeks for some people. So be optimistic 🙂!

It is not uncommon to have a heel spur for 1 year or more. Even if it is annoying, it is not a sign of something more serious.

How long does a heel spur last at most?

As you could see in the previous table, some individuals with or without associated plantar fasciitis did not fully recover several years after the onset of symptoms.

However, this is a minority of people.

Nevertheless, there is no “maximum” duration for a heel spur. The pain may fluctuate over time, but it can persist for several years, even though it disappears in less than a year for the majority of individuals.

How many sick leave days for a heel spur?

In France, the National Health Insurance provides guidelines for physicians to recommend sick leave durations based on specific conditions or operations. However, these guidelines are purely informative, and each physician is free to decide whether or not to issue a sick leave certificate based on the impact of the condition on the individual’s ability to work.

There is no specific guideline for a heel spur.

Based on my experience, if you have a sedentary job, such as an office employee, it is unlikely that you will need to take sick leave.

However, if you have a heel spur and your job requires a lot of walking or standing (e.g., nurse, waiter/waitress, manual laborer, nursing assistant, etc.), a few days to a few weeks of sick leave may sometimes be necessary. This allows time to reduce inflammation and gradually resume activities that trigger or worsen the pain.

Can you walk with a heel spur?

It is absolutely possible to walk with a heel spur. Strict rest, walking with crutches without putting weight on the foot, is not recommended. Although it may provide temporary relief, it is likely that the pain will return once walking resumes.

The ideal approach is to find a balance:

• Walk with or without crutches for varying durations, even if it slightly increases the pain.
• Gradually increase the time spent on activities that trigger or worsen the pain over the course of several days.

You can walk with a heel spur, and using crutches temporarily can help alleviate pressure on the affected foot.

What is the treatment for a heel spur?

The medical or surgical treatment for a heel spur follows similar guidelines to the treatment for plantar fasciitis.

Numerous different techniques are proposed, including:

1️⃣ Non-medicated and non-surgical treatments as a first step:

• Treatment focused on gradual resumption of activity and progressive reloading of the plantar fascia (which I prefer).
• Use of off-the-shelf or custom orthopedic insoles.
• Night splints.
• Stretching exercises.
• Manual therapy.
• Shockwave therapy.
• Physiotherapy (heat, cryotherapy, therapeutic ultrasound, etc.) for pain relief.
• CBD intake for chronic pain relief.

2️⃣ Medicated treatments as a second step.

3️⃣ Interventional treatments as a third step, in case of chronic pain and discomfort:

• Local anesthesia radiotherapy.
• Infiltrations.
• Platelet-rich plasma injections.

4️⃣ Surgical treatments as a last resort (open surgeries of the heel spur and endoscopic plantar fasciotomies).

The majority of these treatments have not been extensively evaluated in clinical trials comparing the outcomes of people who receive specific treatments to those who receive no treatment or a placebo therapy. Often, the effectiveness is assessed by observing the progress of individuals before and after the treatment, without being able to confirm a direct effect of the treatment (individuals might improve over time regardless of the treatment).

What do I recommend and why?

Personally, I base my treatment recommendations on the following criteria for heel spurs:

• The most effective treatment possible (theoretical or empirical efficacy).
• The least time-consuming, energy-consuming, and cost-effective.
• The simplest to carry out.
• With the fewest possible side effects.

Other recommendations from academic publications

Here are the recommendations that emerged from a team of doctors and physiotherapists in the United Kingdom. To formulate these recommendations, the team relied on:

• Studies on plantar fasciitis treatment.
• Expert opinions.
• Surveys of patients suffering from plantar fasciitis.

The best practices suggest that the basic treatment for people with plantar fasciitis should include taping, stretching, and individualized education. Patients whose condition does not significantly improve may be offered shockwave therapy, followed by custom orthoses.

Morrisey 2021

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