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Living with chronic heel pain can be confusing and frustrating. You may have been told you have a heel spur – a bony protrusion on your heel – or have been diagnosed with plantar fasciitis. At Unpain Clinic, we understand this struggle. Many patients expect the spur to be the pain source, but “heel spurs, often blamed for plantar fasciitis, are a normal anatomical structure. They are rarely the real cause of pain”. In fact, research shows heel spurs often appear incidentally on X-ray in people without heel pain. The real culprit is usually inflamed soft tissue – the plantar fascia ligament or nearby tendon – that has been overstressed by foot or whole-body dysfunction. Unpain experts emphasize treating the underlying problem, not just the visible spur.
In this post we’ll explain what a heel spur is, what it feels like, and how it differs from plantar fasciitis. We’ll review the latest science on heel pain, and describe Unpain Clinic’s approach – including shock wave therapy for heel spur pain – to help you find lasting relief.
Figure: X-ray of a right heel (calcaneus) with a calcaneal “heel spur” (arrow) on the underside of the bone. Spurs often show up on imaging, but as Unpain experts note, many people “walk around with heel spurs and never feel a thing”. True pain usually comes from irritated soft tissue.
A heel spur (calcaneal spur) is a small bony growth on the heel bone, often located where the plantar fascia or Achilles tendon attaches. It forms over time due to chronic tension and micro-trauma at that attachment site. For example, a tight plantar fascia pulling on the heel can deposit calcium and form a “hook” or spur. Spurs are very common, especially in middle-aged or overweight individuals, or those with flat feet or poor foot mechanics.
However, a heel spur itself does not have nerves and typically causes no sensation. Most people with spurs have no pain. As our Unpain podcast explains: “If you’ve been diagnosed with a heel spur, don’t panic. Research shows heel spurs are often incidental findings on X-rays, meaning they’re not necessarily the cause of pain”. In other words, seeing a spur on an X-ray does not automatically mean it’s the pain generator.
So, what does heel spur pain feel like? When spurs are symptomatic, the pain usually mimics plantar fasciitis: a sharp or stabbing pain under the heel when you first step out of bed, or a deep ache in the arch after walking. You may feel tenderness on the bottom of the heel or the front part of the arch. If the spur has formed at the back of the heel (where the Achilles attaches), the pain is felt at the back of the heel or lower calf, often worsening with stairs or when pushing off.
What’s the root cause of this pain? Chronic inflammation of the plantar fascia (plantar fasciitis) or Achilles tendinopathy. Tight or weak foot and leg muscles can overload these tissues. The foot may compensate for hip or core weakness by pronating or gripping, which strains the plantar fascia. Indeed, one Unpain patient found that her chronic “heel pain” actually started because her hips were unaligned after a concussion – once the hip issue was corrected, her foot pain improved.
In summary, a heel spur is a byproduct of long-term stress on the foot, not usually a primary pain source. Patients often have classic plantar fasciitis symptoms (morning heel pain, arch stiffness). A recent clinical review notes that calcaneal spurs can cause “localized heel pain, especially during walking or after inactivity (such as rising in the morning)”. Physical exam may show tenderness at the heel’s medial tubercle. X-ray can confirm a spur, but keep in mind that pain usually comes from the inflamed ligament or tendon around it.
The evidence increasingly supports conservative, targeted treatments over surgery for heel spurs. In fact, many randomized trials on plantar heel pain lump “heel spur” and plantar fasciitis together because they overlap so much clinically. A 2025 randomized trial in the Journal of Orthopaedic Science looked at patients with painful calcaneal spurs. They found that focused extracorporeal shock wave therapy (ESWT) significantly reduced heel pain and improved foot function. For example, average morning-pain scores dropped dramatically after treatment (from about 7.8 out of 10 down to 3.4).
Both shockwave and high-intensity laser therapy groups improved, but shockwave yielded slightly better functional gains. The authors concluded that ESWT is an effective non-invasive option for calcaneal spur pain. Similar findings come from studies on plantar fasciitis. A systematic review of 11 trials (658 patients) concluded that ESWT yields moderate improvements in chronic plantar heel pain – reducing pain and improving function better than placebo or sham therapy.
In practice, this means patients often say the heel pain subsides and walking becomes easier after a course of shockwave treatments. Another study used ultrasound imaging to show how ESWT helps: in patients with plantar fasciitis and heel spurs, four weekly ESWT sessions significantly thinned the plantar fascia and relieved pain and disability (VAS and function scores all improved markedly). These data suggest that shockwaves help resolve the inflammation and thickening of the fascia associated with long-term stress.
How does shockwave do this? The mechanism is quite fascinating. Unlike plain ultrasound, shockwave sends high-energy acoustic pulses into the tissue, stimulating healing. As Unpain explains, “shockwave therapy stimulates real healing at the cellular level. It works by sending high-energy sound waves deep into the tissue, breaking down scar tissue, increasing blood circulation, and triggering the body’s natural repair mechanisms”.
Animal studies and imaging studies support this: shockwaves increase blood vessel formation (angiogenesis) in damaged fascia and tendon, and stimulate collagen production to rebuild tissues. In simpler terms, shockwave not only “breaks up” the calcifications of a spur, but also wakes up cells to heal the underlying ligament or tendon.
Taken together, the science suggests: shockwave therapy is safe and often effective for heel spurs/plantar fasciitis; it can reduce pain, improve function, and even remodel injured tissue. It is far preferable to surgery, which is now considered a last resort when all else fails. (As we noted earlier, even Unpain’s team advises, “surgery should be the last resort” because most heel spurs can be treated non-invasively.)
At Unpain Clinic we take a whole-body, root-cause approach to heel pain. Shockwave therapy (focal ESWT) is a centerpiece of our heel spur treatment, but it’s combined with other modalities and therapies. Each patient’s plan is individualized after a thorough assessment. Typically our licensed physiotherapists or chiropractors will perform a motion analysis and look at the entire chain from hip to foot. As one patient noted, the therapist “determined my hips were unaligned… Instead of fixing the trouble area, we went above and beyond to figure out what the main problem is”. This holistic evaluation ensures we don’t just treat symptoms – Unpain’s philosophy is that “pain is only a symptom” and we must “target the source of the condition as well as the symptoms”.
We use state-of-the-art shockwave devices to deliver high-energy waves to the heel. This can include radial shockwave (for surface tissue) or focal (for deeper areas). Shockwave reaches the thickened plantar fascia or Achilles tendon insertion, breaking up scar and calcific tissue while boosting circulation. Patients typically receive treatment on their first visit, and most will get about 3 shockwave sessions, one week apart. Each session is quick (10–15 minutes) and non-invasive. There is no numbing injection needed – most clients describe just a brief sensation of pressure or tingling when the probe is on bone, and it stops when the machine is paused. The goal is to “stimulate the body’s natural repair mechanisms” so the foot can heal properly.
In addition to shockwave, we may use Extracorporeal Magnetotransduction Therapy (a pulse electromagnetic field therapy). EMTT is thought to reduce inflammation and modulate pain signals without pain or manual force. It complements shockwave by calming down hyperactive nerves and jump-starting cellular repair. (This is a newer modality that has clinical support for musculoskeletal conditions.)
If a patient’s foot pain has a nerve component (for example, long-standing plantar pain can sensitize nerves), we might include gentle neuromodulation techniques. These could be low-level laser or electrical stimulation to the heel, or education in nerve-flossing exercises. The aim is to “reset” pain nerves so the brain stops over-reacting to normal foot use. In practice this feels like a soothing, warm treatment with little to no discomfort.
Hands-on techniques (physio or chiropractic adjustments, soft-tissue release) help reduce tightness and correct biomechanics. For example, if the calf or Achilles is very tight, we use targeted massage and joint mobilizations to gain ankle dorsiflexion. If hip or pelvic alignment is off, we incorporate spinal and hip adjustments. As one satisfied patient said: they “provide shockwave with every visit” but also “treat secondary problem areas (i.e. sore foot can affect your knees, etc.), because they look at the whole chain”. In short, we relieve any local stiffness and address gait impairments so the foot and spine move better together.
You will also get a tailored exercise program to do between visits. This may include plantar fascia stretches, calf stretching, and foot strengthening exercises (like towel scrunches or calf raises). Our goal is to support the shockwave with active rehab. Unpain’s experts note that exercises can be very helpful – “stretching and strengthening exercises… can be helpful” – once the dysfunction is corrected. For instance, after clearing pain signals with shockwave, strengthening the glutes and core can prevent the foot from collapsing and re-injuring the fascia. We teach proper technique so you keep loading the foot correctly as it heals.
By combining these therapies – shockwave plus EMTT/neuromodulation plus manual therapy and exercise – we treat the root causes of heel spur pain, not just mask the symptoms. Unlike standard care that might only address the sore spot, Unpain’s integrative method looks at how foot, leg, and body are all connected. Our team of physiotherapists and chiropractors customizes the mix for your needs. (For more on our shockwave program in Edmonton, see our Shockwave Therapy page.
Patients often tell us that this approach makes a real difference. For example, one long-time plantar fasciitis sufferer reported: “I have tried all kinds of treatments for my plantar fascia and Shockwave Therapy is the only thing that has helped relieve the pain in my foot.”. After decades of unsuccessful care, she finally got lasting relief with Unpain’s therapy. In another case a patient came in expecting only a heel adjustment, but the therapist discovered her hips were a bigger issue.
She recalls, “He was able to determine my hips were unaligned… Instead of fixing the trouble area, we went above and beyond to figure out what the main problem is.”. By treating her hip and foot together, along with shockwave for her arch, she achieved significantly better outcomes. These stories illustrate our philosophy: treat the person, not just the site of pain. (Names are withheld for privacy.)
While professional treatment is the most effective path, there are safe steps you can take between visits to support healing. Simple daily exercises and self-care can help keep the foot limber and reduce pain. As Unpain Clinic notes, stretching and strengthening can be helpful once the main dysfunction is addressed. For now, try incorporating:
Always listen to your body: do not push into sharp pain. These tips are meant to maintain flexibility and strength. Over time, as Unpain’s treatment reduces the inflammation, these exercises will complement the healing.
A heel spur is a bony projection (calcification) on the heel bone (calcaneus), typically at the underside near the plantar fascia or at the back where the Achilles attaches. It forms from chronic stress on those attachments. Importantly, a heel spur itself usually does not hurt – many people have spurs without any symptoms. The pain you feel is typically from the plantar fascia or tendon inflammation, not the bone spur itself.
Usually, a true heel spur by itself isn’t felt. People with heel pain (often diagnosed as plantar fasciitis) describe a sharp “stabbing” pain under the heel when taking the first steps in the morning or after sitting, which then eases into an ache. If the spur is on the Achilles side, pain is felt in the back of the heel or calf, especially with pushing off or going upstairs. In general, spur pain feels just like plantar fasciitis pain because the underlying inflammation is very similar.
Plantar fasciitis is inflammation of the ligament (plantar fascia) on the bottom of your foot. A heel spur is a bone growth on the heel. The two often occur together, but they are not the same thing. Plantar fasciitis is the real pain source, whereas a spur is often just a side effect. If you imagine inflammation tugging on the bone for years, it can create a spur, but the pain is from the tissue, not the bone. In other words, many people have heel spurs on X-ray, but only those with plantar fascia inflammation feel pain. Treating the fascia (with rest, exercises, or shockwave) relieves the pain even if the spur remains.
Not usually. Since the spur itself rarely causes pain, surgery to remove it is a last resort. Most studies and experts recommend continuing conservative treatments (orthotics, exercises, shockwave, etc.) for at least 6–12 months before considering surgery. Shockwave therapy is much less invasive and can often break down the spur’s calcified tissue over time, while also healing the soft tissues. Only in very stubborn, rare cases (when all non-surgical options fail) would a surgical procedure be considered.
Shockwave therapy (ESWT) is a treatment that uses high-energy sound waves to stimulate healing in injured tissue. It is not the same as ultrasound or electrical therapy. As Unpain Clinic explains, these waves “break down scar tissue, increase blood circulation, and trigger the body’s natural repair mechanisms”. For heel pain, we apply the shockwave device to the painful area (plantar fascia or Achilles insertion) in short pulses. This kick-starts the healing process so that your own body can repair the tissue. It may also help dissolve any calcium buildup from a spur. [✔] Expert tip: Shockwave therapy is evidence-based and FDA-approved for plantar fasciitis.
Most patients find shockwave very tolerable. You may feel a tapping or mild pressure at the bony area during each pulse. The sensation usually lasts only a few seconds and stops when the machine does. It is common to feel some warmth or mild ache during the session, but no needles or anesthesia are needed. If you have low pain tolerance, let us know – we can adjust the intensity. Generally, people who have had shockwave say it is “painless” or only mildly uncomfortable. Any soreness afterwards is usually brief.
In most cases, 3 shockwave sessions are scheduled, about one week apart. We often perform the first treatment on your initial visit, after the assessment. Many patients feel some improvement even during the first session – for example, pain may lessen immediately after the shockwave. However, real healing takes time. As explained by our therapists, tissues continue to repair over the next 4–6 weeks. Most clients notice significant relief within 4–6 weeks after the series of treatments. By about 6 weeks post-treatment, many feel a dramatic difference. If pain has not sufficiently eased after that period, a fourth session may be scheduled.
Heel spurs are common, but remember: spurs themselves are usually harmless. The throbbing or stabbing pain most people feel is often due to plantar fasciitis or tendon stress. The key is to treat the source of inflammation and correct underlying biomechanics, not just the bony spike. Evidence shows that shockwave therapy – along with supportive therapies – can significantly reduce heel pain and restore function. Unpain Clinic’s patient stories and protocols back this up: with thorough assessment and combined treatments, many clients finally find relief when “try everything else” approaches have failed.
Book Your Initial Assessment NowAt Unpain Clinic, we don’t just ask “Where does it hurt?” — we uncover “Why does it hurt?”
If you’ve been frustrated by the cycle of “try everything, feel nothing,” this assessment is for you. We take a whole-body approach so you leave with clarity, not more questions.
✅ What’s Included
Comprehensive history & goal setting
Orthopedic & muscle testing (head-to-toe)
Motion analysis
Imaging decisions (if needed)
Pain pattern mapping
Personalized treatment roadmap
Benefit guidance
🕑 Important Details
60 minutes, assessment only
No treatment in this visit
👩⚕️ Who You’ll See
A licensed Registered Physiotherapist or Chiropractor
🔜 What Happens Next
If you’re a fit, we schedule your first treatment and start executing your plan.
🌟 Why Choose Unpain Clinic
Whole-body assessment, not symptom-chasing
Root-cause focus, not temporary relief
Non-invasive where possible
No long-term upsells — just honest, effective care
🎯 Outcome
You’ll walk out knowing:
What’s wrong
Why it hurts
The fastest path to fix it
Author: Uran Berisha, BSc PT, RMT, Shockwave Expert
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