A heel spur is a bony growth on the heel bone visible on an X-ray, but heel pain usually comes not from the spur itself but from overload of the plantar fascia. Shockwave therapy is one of the methods with documented effects for chronic heel pain and is used together with exercise. It does not “break up” the spur. In Rydułtowy the treatment costs PLN 100.
Below we explain where heel pain comes from, when to see a doctor first, what you can expect from shockwave therapy and which 3 exercises are worth doing at home.
In brief
- Some people have a heel spur on an X-ray without any pain, so the spur alone does not determine the cause of the symptoms.
- A typical sign of plantar fascia overload is pain with the first steps in the morning and after sitting for a long time.
- Shockwave therapy costs PLN 100, and combined with manual therapy PLN 200.
- The physiotherapist decides on the number of treatments individually after the consultation (PLN 180).
- The clinic in Rydułtowy: Mon–Fri 7:00–20:00, private visits only (not covered by NFZ, the Polish public health fund).
Contents
What is a heel spur and why does the heel hurt?
A heel spur is a bony outgrowth where the plantar fascia and foot muscles attach to the heel bone. Heel pain, however, is most often caused by overload of the fascia itself, a band of connective tissue running from the heel to the toes. Typical is a stabbing pain under the heel with the first steps in the morning, which eases once you get moving but returns after exertion.
Risk factors include excess weight, standing work, a sudden increase in walking or running, restricted ankle mobility and a stiff calf. The pain more often affects people between the ages of 40 and 60.
When should you see a doctor first about heel pain?
It is worth seeing a doctor before physiotherapy if the heel pain appeared after a fall or jump, if the heel is swollen, red and hot, if it also hurts at rest and at night, with numbness or burning in the foot, with pain in both heels together with pain in other joints, and in children and teenagers during growth.
Pain when the heel is squeezed from the sides in people who run a lot may indicate a stress fracture. Wounds and ulcers on the feet of people with diabetes also need urgent assessment. Doctors the clinic works with are listed on the Recommended specialists page.
Does shockwave therapy help with a heel spur?
Yes, in guidelines on heel pain, shockwave therapy is recommended as one of the methods for chronic symptoms, especially when exercise and a change of footwear have not brought enough improvement. It acts on the fascia and the tissues around the attachment, not on the bony growth itself. It works best combined with stretching and strengthening of the foot and calf muscles.
Before the treatment, the physiotherapist confirms that the pain is due to plantar fascia overload and checks for contraindications. These include pregnancy, blood clotting disorders and anticoagulant treatment, cancer in the treatment area, skin infection or inflammation, and in children – the area of the growth plates. A comparison with another treatment can be found in our article TECAR or shockwave therapy – which to choose.
Shockwave therapyfor chronic heel pain and overloaded tendon attachments100 PLNPrices valid from 08.2026.
What else helps with heel pain?
Apart from shockwave therapy, the following help: daily stretching of the plantar fascia and calf, foot-strengthening exercises, cushioned footwear with a slightly raised heel, temporarily cutting down on long periods of standing and running, and – for some people – insoles, foot taping or a night splint. For people who are overweight, losing weight is important. A steroid injection is considered by a doctor.
Manual therapy of the ankle and calf can help when restricted mobility increases the load on the fascia. If symptoms last many months despite treatment, a doctor may consider further investigations, e.g. an ultrasound scan.
Which exercises should you do for a heel spur?
With plantar fascia overload, exercises that stretch the fascia and calf and gradually strengthen the foot muscles are usually safe. Stretching the fascia is especially worthwhile in the morning, before your first steps. The 3 exercises below are general. Pain during the exercises should not exceed 3–4 on a 0–10 scale and should not increase the next day.
- Plantar fascia stretch. Sitting, place the painful foot on the knee of the other leg and pull your toes back towards you until you feel tension under the foot. 10 times for 10 seconds, in the morning before getting up and twice during the day.
- Calf stretch against a wall. Rest your hands on the wall, step the painful leg back, heel on the floor, knee straight. 3 times for 30 seconds, twice a day.
- Heel raises with a towel under the toes. Stand on a step, place a rolled-up towel under the toes of the painful foot, hold on to the handrail and slowly raise and lower your heel. 3 sets of 10–12 repetitions, every other day.
If the pain gets worse or spreads, stop the exercise and consult a physiotherapist.
Good to know: bring to your visit the shoes you most often walk or run in, and the X-ray or ultrasound report of your foot, if one was done.
We describe other foot and joint problems in our guide joint pain and injuries.
Summary
Heel pain with a heel spur usually results from overload of the plantar fascia, not from the growth itself. Shockwave therapy (PLN 100) is one of the methods for chronic pain, ideally combined with daily stretching and strengthening. Pain after an injury, at night or with numbness requires a doctor first.
Frequently asked questions
Does shockwave therapy on the heel hurt?
The treatment can be unpleasant, because the heel is tender when the plantar fascia is overloaded. The patient feels a rhythmic tapping, and the physiotherapist sets the intensity so that it is bearable and can change it during the treatment. After the treatment you can return to your everyday activities, although the heel may be more sensitive for a while.
How many shockwave treatments are needed for a heel spur?
The physiotherapist decides on the number of treatments individually after the consultation, taking into account how long the pain has lasted, the response to the first treatments and whether you do the exercises at home. Before each subsequent treatment they assess whether the pain is decreasing. A single treatment costs PLN 100, and combined with manual therapy PLN 200.
Does a heel spur need surgery?
The vast majority of people with heel pain do not need surgery. Conservative treatment – exercises, footwear, insoles, shockwave therapy and possibly an injection – is usually enough. A doctor considers surgery only in exceptional cases, when severe pain persists for a very long time despite properly conducted conservative treatment, including exercise.
Can I run with a heel spur?
Often you can, but with lower volume, on soft surfaces and in shoes with good cushioning. Running should not make the morning heel pain worse the next day. If it does, it is worth temporarily replacing it with cycling or swimming and agreeing a plan for a gradual return with a physiotherapist.
Do I need a referral for shockwave therapy?
For a private treatment at the “W zdrowym ciele” clinic a referral is usually not required, but before the first treatment the physiotherapist takes a medical history and carries out an examination. The clinic has no contract with the NFZ (the Polish public health fund). It is worth bringing X-ray or ultrasound results of the foot and a list of the medicines you take, especially anticoagulants.
Can I walk barefoot with heel pain?
With severe heel pain, walking barefoot on hard floors usually makes the symptoms worse, especially in the morning. It is better to keep cushioned footwear by the bed and put it on from your very first steps. Walking barefoot on soft surfaces can be introduced gradually once the pain has clearly decreased.
Sources
- Koc T.A. et al., Heel Pain – Plantar Fasciitis: Revision 2023. Clinical Practice Guidelines, JOSPT, 2023.
- NICE, Extracorporeal shockwave therapy for refractory plantar fasciitis (IPG311), 2009.
- Rathleff M.S. et al., High-load strength training improves outcome in patients with plantar fasciitis, Scandinavian Journal of Medicine & Science in Sports, 2015.
About the author: Tatiana Grabowska, MSc – master’s degree in physiotherapy, licence to practise number PWZFz 11646 (Polish licence to practise as a physiotherapist). Since 2013 she has run the “W zdrowym ciele” physiotherapy and rehabilitation clinic in Rydułtowy; she has about 12 years of professional experience. Physiotherapist’s profile
- Consultation180 PLN
- Referralnot needed
- ReceptionMon–Fri: 7.00–20.00
