The term "bone spur" tends to conjure images of something sharp and painful — but the reality is more nuanced. Many people walk around for years with bone spurs in their feet and never feel a thing. When they do cause pain, though, the discomfort can be significant and disruptive to daily life. Understanding what bone spurs are, where they form, and how they're treated can help you make informed decisions about your foot health.

What Is a Bone Spur?

A bone spur (osteophyte) is a small, smooth outgrowth of calcium that forms on the edge of a bone over time. Contrary to the name, they're rarely sharp — they're typically smooth projections that develop gradually as the body attempts to repair and reinforce stressed or damaged bone. The problem arises when these deposits press on nearby soft tissues, nerves, or tendons.

Bone spurs are very common in the feet, where bones, joints, and tendons endure significant mechanical stress day after day.

Where Do Bone Spurs Form in the Foot?

The heel is by far the most common location for foot bone spurs. A heel spur typically forms on the underside of the calcaneus (heel bone), often at the point where the plantar fascia attaches. But spurs can also develop in other areas:

  • Top of the foot — often forming near the mid-foot joints, sometimes causing a visible bump
  • Back of the heel — where the Achilles tendon attaches (Haglund's deformity is related to this area)
  • Big toe joint — associated with hallux rigidus (stiff big toe) or advanced bunion
  • Lesser toe joints — can contribute to toe stiffness and difficulty wearing shoes

What Causes Bone Spurs?

Bone spurs don't appear overnight. They develop in response to chronic stress, inflammation, or wear on the bone. Common causes include:

  • Repetitive stress and overuse — running, walking long distances, or standing for extended periods places repeated strain on the same structures
  • Plantar fasciitis — the most strongly associated condition; chronic tension and micro-tears at the plantar fascia insertion trigger calcium buildup over time
  • Osteoarthritis — as joint cartilage wears away, the body compensates by forming extra bone at the joint margins
  • Flat feet or high arches — abnormal foot mechanics shift stress unevenly across foot structures
  • Ill-fitting footwear — shoes that crowd toes or lack arch support contribute to chronic stress
  • Age — the likelihood of bone spurs increases with age as cumulative wear accumulates

Symptoms: Painful vs. Asymptomatic Spurs

This is a critical distinction. A significant number of heel spurs are found incidentally on X-rays taken for unrelated reasons — the patient had no idea the spur existed. The spur itself isn't always the direct cause of pain; often, the surrounding inflamed soft tissue is to blame.

When bone spurs do cause symptoms, you may notice:

  • A sharp or aching pain in the affected area, especially with the first steps in the morning
  • Tenderness when pressing on the area
  • Swelling or warmth near a joint
  • A visible or palpable bump on the foot
  • Reduced range of motion in nearby joints
  • Pain that worsens with activity and eases with rest, then returns after prolonged sitting

Diagnosis

A podiatrist can often identify a bone spur based on a physical examination and your symptom history. However, confirming the diagnosis requires imaging. A standard weight-bearing X-ray of the foot is the most common tool — it clearly shows calcified deposits on bone. In some cases, an MRI or ultrasound may also be ordered to assess the condition of the soft tissues around the spur.

Treatment Options

Because many spurs are asymptomatic, treatment focuses on relieving symptoms rather than removing the spur itself. Conservative options are effective for the vast majority of patients:

  • Custom orthotics — prescription insoles redistribute weight and relieve pressure on the spur, while correcting any biomechanical abnormalities contributing to the problem
  • Supportive footwear — shoes with adequate cushioning and arch support reduce impact on painful areas
  • Stretching and physical therapy — calf stretches, plantar fascia stretches, and targeted strengthening exercises can significantly reduce associated inflammation
  • Anti-inflammatory medications — over-the-counter NSAIDs (ibuprofen, naproxen) help manage pain and swelling
  • Cortisone injection — a corticosteroid injected near the spur can provide powerful short-to-medium-term pain relief
  • Night splints — keep the plantar fascia stretched overnight to reduce morning pain

Surgery to remove a bone spur is rarely necessary and is reserved for cases where conservative treatment has failed over a prolonged period and the spur is clearly compressing a nerve or tendon. When surgery is needed, recovery typically takes several weeks.

Can You Prevent Bone Spurs?

You can't always prevent them — especially when genetics or arthritis are involved — but you can reduce your risk:

  • Wear well-fitting, supportive shoes appropriate for your activity level
  • Stretch your calves and plantar fascia regularly, especially before exercise
  • Maintain a healthy weight to reduce mechanical load on the feet
  • Address foot pain early before it becomes a chronic problem

If you're experiencing persistent heel pain or a tender bump on your foot, our podiatrists at Big Sky Foot & Ankle can help. Serving Butte, Bozeman, Anaconda, and Ennis, Montana.

Related: Heel Pain Treatment in Montana