Podiatrist (Foot and Ankle Specialist) Questions bone growth

I have a bone growth under my heel and it hurts. What should I do?

I have a bone growth right under my heels and its hurting very badly. What should I do about it?

11 Answers

Hi, It could be a bone spur, If you've already had this evaluated. Unless you had an injury, it's most likely the soft tissue called the plantar fascia that is attached to the bone spur that is causing pain. It should be treated with rest, stretching, support, anti-inflammatories, physical therapy, orthotics and managed by your podiatrist
If the bone growth your referring to is a heel spur. You might find relief, (if you have an high arched foot) with a 3/8 inch heel lift.
You heel maybsurly hurt but it is not from the spur. It’s fasciitis.
Stretch ice an anti inflamitories. To start.
May try a silicone heel cup, but ultimately may need surgical intervention to alleviate the abnormal growth. Should also have at a minimum an X-ray to evaluate for other conditions.
It could be the bone spur or it could be the ligament that is causing the pain. There needs to be icing and stretching. To remove the bone growth could require a surgical procedure.
Response to having a bone growth under your heels. There are multiple treatments that can occur depending on what exactly the diagnosis is. Usually, the bone growth under the heel comes from a condition called plantar fasciitis. Please check with your primary care doctor or find a podiatrist in your area who can treat you appropriately. One of the protocols now that we are doing his we are using regenerative/stem cell therapy. This does not remove the bone growth, but the last thing one should do is remove bone growth in the heel area.

Dr. Mark Gorman
You may have a heel spur, or you may not and may still have significant pain from a problem with a ligament on the bottom of your foot. The problem is called Plantar Fasciitis.

The most common cause of heel pain that I see in my practice is caused by a pathology called "Plantar Fasciitis." People usually come in complaining of pain at the inside of their heel or along the bottom of the arch that came on suddenly. Symptoms usually consist of pain that starts with the first step out of bed in the morning, after getting up out of a seated position, and pain that may extend around the back of the heel and up the back of the leg as the disease progresses.

What is Plantar Fasciitis? The plantar fascia is a ligament that runs from the bottom of the heel to the ball of the foot. A ligament is a thick, fibrous structure that attaches one bone to another bone, and is present for structural support. The plantar fascia is one of the major supports for holding up the medial arch of the foot. The reason that the plantar fascia gets irritated is usually from a combination of causes. It often occurs if a patient has recently had a gain in weight, or sometimes when there has been a recent change in activity level. Often, a patient will have recently started a new exercise regimen, which causes increased stress on the ligament and along the arch. Also, peoples’ arches often begin to fall, or flatten as they get older, and this may also cause stress to the plantar fascia. This causes an inflammatory process along the course of the ligament, or at its insertion on the heel, which causes pain. The reason the ligament hurts after periods of rest is simple. When a patient is not standing, there is no stress along the arch or on the ligament. The ligament then has a chance to begin healing. The moment the foot hits the ground, all of the healing that may have been done, gets undone, and the inflammatory response begins all over again. This becomes a repetitive cycle, and the pain may become worse and worse as the pathology progresses.

So, how do we treat Plantar Fasciitis? There is a standard regimen that I use for my patients experiencing this problem. The fastest way to get rid of the inflammatory response is to give the patient a cortisone injection. Though unpleasant, most patients are happy to try to get rid of the pain swiftly. The foot is then strapped to support the arch so the ligament does not tighten up with weight bearing and activity. A strict course of icing and stretching is instated for the patient. Further injections may be given, but a patient should generally never have more than 3 injections in the same area more than 3 times in a 12 month period. Doing so may weaken the soft tissues. Orthotics are also very effective in preventing the problem from recurring, and help the patient with over-all function and balance. In fact, orthotics not only help to support the medial arch, but they help to balance out the knees, hips and low back, and help to prevent muscle fatigue. Surgery is rarely indicated for Plantar Fasciitis. In fact, the current literature states that unless a patient has had this problem for a minimum of 9 months, and has been compliant with all of his physical therapy and conservative therapy, surgery should not be performed. Surgical correction of this problem involves cutting the ligament, and this will eventually lead to an over-all weakening of the medial arch, and weaken the structure of the foot, in general.

I have a great deal of success treating Plantar Fasciitis with my patients, and usually am able to make a patient pain free within 2 weeks to 2 months, in extreme cases. The longer the pain is present, the harder it is to get rid of. So, if you are experiencing heel pain, be sure to see your local foot and ankle specialist as soon as possible for the best results!

Lee Wittenberg, DPM
The growth or heel spur in and of itself is usually not a problem. The pain you are experiencing when you step down can be treated with injection icing stretching and custom orthotics. Do not wear flat shoes or walk barefoot. See your podiatrist ASAP as this condition will get worse if untreated.
Bone growths that are sudden are not a very common thing, but it's always a good idea to have it evaluated by a foot and ankle specialist to obtain a definitive diagnosis and treatment plan.
Most of the time pain under the heel is from plantar fasciitis. You can have a heel spur present but it is usually the plantar fascia. You would need an X-ray to confirm presence of the bone growth
At one point, I think 1/2 of my new patients complained of excruciating heel pain. Usually, the patients told me their first few steps to the bathroom in the morning were incredibly painful and if they were seated for a half hour or so, then got up, they suffered the same terrible pain.

Early on, we were confused about the presence of a bone spur. Some patients had terrible pain and no spur while other patients complaining of a different problem and no heal pain had huge, asymptomatic spurs. It turns out, the spur doesn't cause the pain. Most spurs point upward, so the spur never comes in contact with the ground when standing. The plantar fascia that runs from just below the spur to the metatarsals supports the arch of the foot. I could reproduce the pain by pushing on the fascia at the heel.

Most patients got relief with an arch support in their shoe; some needed a shot of cortisone in addition. A few did not respond to this regimen and needed to have a surgical release of the inner part of the fascia. I developed an arthroscopic procedure requiring two small incisions. Patients could walk almost immediately and could return to work symptom-free much sooner than with a spur removal.

It's important to see a foot and ankle surgeon who performs this arthroscopic procedure if surgery is needed, and will not bother with the spur. Spur removal is incredibly painful post-operatively, and removal can result in a fracture to the heel bone.

Good luck with your problem,

Rod Tomczak, MD, DPM, EdD