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There is a misconception that heel pain is associated with a heel spur. Some people have even been diagnosed with heel spur syndrome. The reality is that heel pain is usually due to inflammation of the plantar fascia also known as plantar fasciitis. One of the key indicators is pain at the heel when first stepping on the floor getting out of bed in the morning. I have had patient with heel pain and no heel spur present on x-ray and also have had patients with heel spurs present on x-ray who received x-rays for a different ailment and have never had heel pain. The spur, if it is present, is there because the ligament is tight or from excess pull of the abductor hullucis muscle at the origin. The idea is to treat the inflammation of the plantar fascia and decrease mechanical stress at the bottom of the heel for more long term alleviation. It does take some time and patience to treat, but the condition does improve.