Surgery for heel spur syndrome?

Originally Published: February 16, 1995 - Last Updated / Reviewed On: August 16, 2013
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Dear Alice,

A friend of mine has been diagnosed with heel spur syndrome by his podiatrist. The prognosis is surgery and then recovery for two months. Are there any alternative steps that can be done which will provide the same results? That is relieve the pain other than the usual steps like, orthopedic shoes, sole supports, etc. Thanks.

— Ride 'em cowboy

Dear Ride ‘em cowboy,

It’s very difficult to answer your question without knowing more about your friend’s condition. For example, how long has your friend been experiencing symptoms? Has he sought a second opinion? Has he tried other treatments? While it’s impossible to hypothesize treatment options for your friend without more information, there are some general recommendations to discuss that might shed some light on the situation. Namely, that the great majority of individuals with heel spurs, plantar fasciitis, and other types of heel pain are able to resolve discomfort without surgery or other intensive or invasive treatments. In fact, 90-95% of heel spur patients are able to resolve pain without surgery.

Heel pain is relatively common and usually resolves itself. However, if discomfort lasts for weeks, it’s wise to consult with a health care provider or podiatrist, something your friend has already done. Diverse non-surgical treatments for heel spur syndrome abound, and are usually recommended long before surgery is considered. Most experts recommend trying non-surgical treatments for up to ten months before thinking about surgery. Here are some general recommendations that people with heel spur syndrome may try under the supervision of a health care provider or podiatrist:

  • Pinpoint the source of pain. Sudden changes or increases in physical activity as well as prolonged standing are possible causes. If there’s been no change to physical activity lately, taking a break from any other activities that a person suspects may be the source of the problem, such as high-impact sports or other athletic activities, may be wise. If a problem is identified, a person may want to consider avoiding that activity for a period of time determined by her/his health care provider. Or, some folks may want to simply change up their exercise routine to avoid the pain — swimming or upper body weight lifting may be appropriate alternatives.
  • Icing affected areas when possible, especially after strenuous or high-impact activity or long periods of standing, may help the pain dissipate. It’s important to ice the affected area properly, and consult with a health care provider about how to position the ice pack and how long to use it.
  • Warm up before engaging in physical activity, and stretch the calf area throughout the day. Stretching the calf muscle can help relax other muscles and tissues near the heel, which can help alleviate symptoms.
  • Talk to a health care provider or podiatrist about massage therapy for heel spur syndrome. A licensed message therapist or physical therapist may be very useful in treating pain associated with heel spurs or, a related condition, plantar fasciitis.
  • As you mention, wearing arch supports, insoles, heel cups, and other supportive footwear can lead to significant improvement of symptoms. If necessary, prescription orthotics, walking aids, or night splints may also be used.
  • If a person is overweight or obese, adjusting the diet to lose weight may help alleviate pressure on the affected area.  
  • Prescription and over-the-counter anti-inflammatory drugs may be taken to treat pain associated with heel spurs and plantar fasciitis. However, long-term use of these drugs is not recommended as treatment.
  • If pain is severe enough, corticosteroid injections may be used to treat heel pain. However, injections near the heel are tricky and may result in various negative side effects, such as fat necrosis (the degradation of fatty tissue in the area).
  • A health care provider may also consider extracorporeal shock wave therapy, a treatment that sends shock waves through the foot to help relieve pain. Although this procedure is not surgical, along with surgery, it is considered a last resort to resolve heel pain.

These general recommendations may not apply to your friend’s particular condition; however, knowing more about the typical treatment and prognosis for heel spur syndrome can help your friend make an educated decision regarding surgery. Consider encouraging your friend to seek a second opinion if she or he hasn’t already done so. Columbia students can get a podiatrist referral through Medical Services (Morningside campus) or Student Health at the Medical Center Campus. Wishing your friend the best of luck!

Alice