Foot & heel
Heel Spurs & Heel Pain | North Vancouver
An X-ray showed a bony spur on your heel and now you're worried it needs cutting out. Usually it doesn't. The spur is often just a bystander, and the heel pain settles by treating the tissue around it.
What it is
Understanding your heel spur / heel pain.
A heel spur is a small calcium growth on the underside of the heel bone. It shows up on an X-ray and the name sounds alarming, but the spur itself is frequently painless. What people actually feel is the irritation in the soft tissue around it: sharp or stabbing pain in the heel on the first steps in the morning, an ache after standing or walking for a while, and tenderness when you press the bottom of the heel. At Medstar Sport Physio in North Vancouver, we assess and treat this through a one-on-one physiotherapy appointment, confirming the pattern and building a plan from there. We see patients from across Vancouver and the North Shore, many of whom cross Lions Gate Bridge or take the SeaBus for treatment here.
Spurs build up slowly, over years, as the body lays down extra bone where the tissues that attach to the heel are under repeated strain. The usual suspects are familiar: running and jumping that pounds the heel, flat feet or very high arches that load it unevenly, tight calves and a stiff Achilles that crank tension into the heel, unsupportive footwear, and extra body weight. Plantar fasciitis very commonly rides along with it.
Here's the part that changes how this gets treated: the spur is often an incidental finding, and the real driver of the pain is usually the plantar fascia and surrounding tissue under load. That's why chasing the spur with surgery is rarely the answer. You can settle the symptoms by addressing the tissue, the mechanics, and the load, and most people do exactly that without an operation. If the fascia is the lead actor for you, our plantar fasciitis page goes deeper on that side.
What to expect
The spur itself doesn't dissolve, and it doesn't need to. What changes is the irritation in the tissue around it, and that responds well to loading, offloading, and mechanics work. Many people turn the corner within several weeks; long-standing, chronic heels often need a few sessions of shockwave layered on top and a bit more patience. Surgery is rarely necessary and we treat it as a last resort, not a first move.
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Common questions
About heel spur / heel pain.
Does the heel spur need to be removed?
Almost never. The spur is usually an incidental finding rather than the cause of the pain. The soft tissue around it is typically what hurts. Treat the fascia, the calf, the mechanics, and the load, and most heels settle without ever touching the spur. Surgery is reserved for severe, persistent pain that hasn't responded to conservative care.
What's the difference between a heel spur and plantar fasciitis?+
They overlap so often that people use the terms interchangeably, but they're not the same. A heel spur is the bony growth on the X-ray. Plantar fasciitis is irritation of the fascia along the bottom of the foot. The spur is frequently the bystander; the fascia is usually the real driver of the morning-stab pain. Our plantar fasciitis page covers the fascia side in more detail.
Why does it hurt most with the first steps in the morning?+
Overnight the fascia and calf tighten up while you're off your feet. The first steps suddenly stretch that stiff, irritated tissue against the heel, which produces the classic sharp morning stab. It often eases as you walk and the tissue warms up, then returns later in the day after time on your feet.
Can I keep walking and training on it?+
Usually yes, at a managed level. Total rest tends to let the calf and fascia stiffen further. The aim is to keep moving while taking the worst of the load off the heel with footwear, insoles, and smarter training volume, and to build the calf and foot strength that lets the heel tolerate activity again.
What actually causes a heel spur to form?+
A heel spur builds up slowly over years as the body lays down extra bone where tissues attaching to the heel are under repeated strain. Common contributors include running and jumping that pounds the heel, flat feet or very high arches that load it unevenly, tight calves and a stiff Achilles, unsupportive footwear, and extra body weight.
Do I need orthotics or shockwave therapy for a heel spur?+
Not always, but they help in specific cases. Supportive footwear and cushioned insoles or custom orthotics offload the heel through the day for most people. Shockwave or laser therapy is reserved for stubborn heel spur pain that hasn't responded to loading and offloading alone, and is typically layered on top of the core rehab rather than used by itself.
How long does heel spur treatment take?+
The spur itself doesn't dissolve and doesn't need to, since the irritation in the surrounding tissue is what actually responds to treatment. Many people turn the corner within several weeks. Long-standing, chronic cases often need a few sessions of shockwave layered on top and a bit more patience before the heel settles.
How do I stop heel spur pain from coming back?+
Education on footwear, training modifications, and long-term habits is part of heel spur treatment, precisely to stop the strain from returning. Once the initial pain settles, keeping up supportive footwear, sensible training volume, and calf and foot strength work is what keeps a heel spur from flaring again after you've put in the work to calm it down.
Reviewed by Amir Ahmadi, PhD, MSc PT, Registered Physiotherapist, Certified IMS Therapist, College of Physical Therapists of British Columbia (CPTBC). Last reviewed July 2026.
This page is for general information only and does not constitute medical advice, diagnosis, or treatment. Individual presentations vary, and assessment findings and treatment plans differ from person to person. If you are experiencing severe symptoms, neurological changes (numbness, weakness, bowel or bladder changes), or a significant trauma, contact your physician or emergency services. Physiotherapy at Medstar Sport Physio & Health is provided by physiotherapists registered with the College of Physical Therapists of British Columbia (CPTBC).