Shockwave therapy for heel spurs in London

A heel spur on its own often causes no symptoms at all: it is a finding on an X-ray. When there is pain, it is usually felt under the heel, and it behaves like the pain the NHS describes for plantar fasciitis: pain on the bottom of the foot around the heel and arch, worse after rest, easing as you move, then worse again after long periods of standing or walking.

That overlap is the whole story of this page. The spur and the painful tissue sit at the same spot, and a 2012 study of 108 people with heel pain and spurs found that the pain could improve with no change in the spur on the X-ray. The painful structure is usually the soft tissue around the spur, which is covered on the plantar fasciitis page.

Plantar fasciitis is a problem of the thick band of tissue running along the sole, where it attaches to the heel bone. A heel spur is bone: an outgrowth on the underside of the heel bone, near that same attachment. A 2017 review in the Journal of Anatomy lists plantar fasciitis among the conditions most associated with heel spurs, which is why the two turn up together so often.

For treatment, the difference matters less than it sounds. The pain usually comes from the soft tissue, the first treatments are the same, and the only UK guidance on shockwave for the heel is NICE's assessment of refractory plantar fasciitis. If an X-ray has shown a spur, it does not change the order of the next steps, and it does not by itself mean you need extracorporeal shockwave therapy.

Nobody is certain. The 2017 anatomical review describes how spurs form as a contentious issue, with several competing theories, from repeated traction and compression to slow degenerative change. What it does list clearly are the factors most associated with them:

• increasing age
• a higher body weight
• long-running plantar fasciitis
• inflammatory arthritis
• foot position that raises load under the heel

Those associations explain why a spur often turns up in someone who already has heel pain, and why treating the load on the heel matters more than the bone itself.

Shockwave does not remove heel spurs. In the 2012 study of 108 people treated once a week for five weeks, no one had a significant reduction in the spur, and the authors found no correlation between what the X-ray showed and how the heel felt. The study had no comparison group, so the pain changes it reported cannot be separated from time and natural recovery, and this site does not quote them.

NICE has no guidance on shockwave for heel spurs. Its heel assessment, IPG311, covers refractory plantar fasciitis and found no major safety concerns while the evidence on efficacy is inconsistent. So the honest reading is that shockwave for a painful heel with a spur is treatment of the heel pain, judged by the same evidence as plantar fasciitis.

The first treatments are the ones the NHS lists for plantar heel pain: stretching, supportive footwear, insoles or heel pads, and specialist exercises from a physiotherapist or podiatrist. The NHS names steroid injections and shockwave as further options, and surgery as less common. Removing the spur is rarely the answer to heel pain, given how poorly the spur tracks the pain.

London Shockwave Therapy arranges an assessment at one of four UNTIL clubs, where a registered clinician examines the heel and checks what has already been tried before any course is agreed. London Shockwave Therapy sets no fees of its own, and published London prices checked on 29 September 2026 ran from £85 to £150 a session and £348 to £400 for a course of three, set out on the shockwave therapy prices page. To start, ask about your case.

The NHS self-care advice for plantar heel pain applies to a painful heel with a spur: rest and raise the foot when you can, use an ice pack for up to 20 minutes every 2 to 3 hours, wear shoes with cushioned heels and good arch support, try insoles or heel pads, do gentle stretches, and swap to low-impact exercise such as swimming for a while. It also advises avoiding high heels, flip-flops and walking barefoot on hard surfaces.

Stretching the calf and the sole of the foot, and then strengthening the calf, are the usual starting points. The plantar fasciitis page explains why the loading work is what changes the tissue over time.

The NHS advises seeing a GP if the heel pain is severe, if it is getting worse or has not improved after 2 weeks of treating it yourself, or if you also have tingling or numbness in the foot. Tingling or numbness points away from a simple heel problem and needs examining before any treatment.

A GP or physiotherapist can confirm whether the pain is coming from the plantar fascia, the fat pad under the heel, the Achilles tendon at the back of the heel or a nerve. That matters, because each takes a different path, and Achilles tendinopathy at the back of the heel has its own page and its own NICE guidance.

If your heel pain has lasted months despite footwear, stretching and loading, an assessment is the next step. London Shockwave Therapy arranges assessments at four UNTIL clubs, with walking times from the TfL journey planner: 280 Bishopsgate, about 7 minutes from Liverpool Street station; 111 Charing Cross Road, about 5 minutes from Leicester Square; 1 Orchard Street, about 8 minutes from Marble Arch; and 30 South Colonnade, about 2 minutes from Canary Wharf.

Every club opens at 06:00 on weekdays, so a session can fit before a day on your feet, and every club has a gym floor where the calf strengthening that goes alongside a course can carry on.