A heel spur is a calcium deposit that forms a bony projection on the underside or back of the heel bone, typically developing in response to chronic tension or inflammation in the surrounding soft tissue.
Where heel spurs form and how they relate to heel pain
Heel spurs most commonly develop on the underside of the heel bone, at the point where the plantar fascia — the band of tissue that supports the arch — attaches. They form gradually as the body lays down calcium in response to repeated pulling and micro-stress at that attachment point. A heel spur on the back of the heel can also develop where the Achilles tendon inserts. Many people discover a heel spur on an X-ray and assume it explains their pain, but the relationship isn't that direct. The spur itself is often painless — it's the surrounding inflamed tissue that hurts. That means two people with similarly sized spurs can have very different pain experiences, and treating the spur without addressing the tissue irritation and mechanical load that caused it rarely resolves the problem.
Why heel spur pain doesn't respond to rest alone
The soft tissue inflammation and fascial tension that contribute to heel spur symptoms tend to persist unless the load patterns driving them are addressed. Stretching, strengthening, footwear changes, and targeted physical therapy can meaningfully reduce pain even when the spur remains present on imaging.
Why imaging findings don't always explain symptoms
It's common for people to be told their pain is caused by a heel spur and to pursue treatments focused on the bony deposit — including interventions that carry real risks — when the actual driver of pain is the plantar fascia or Achilles tendon insertion. A physical therapist can help clarify what's generating your symptoms and focus treatment accordingly.
How Sword Health can help
A physical therapist can assess what's actually driving your heel pain, address the tissue tension and movement patterns involved, and guide you through a plan that targets the source rather than the imaging finding. Sword makes that level of care available from home, so you can start feeling better without a prolonged wait.
About the author
Carolina Moreira
Medical Director of Clinical Development at Sword Health
