Heel Spur vs. Plantar Fasciitis: What's the Difference and How to Diagnose?

Are you experiencing heel pain and unsure whether it’s a heel spur vs plantar fasciitis? Understanding the difference between these two conditions is essential for proper diagnosis and treatment.

In this blog post, we’ll explore the distinctions between heel spurs and plantar fasciitis, their common causes, and risk factors, as well as the various treatment options available.

Equip yourself with the knowledge to make informed decisions about your foot health and take the first step towards pain-free living.

Defining Heel Spurs and Plantar Fasciitis

Heel spurs and plantar fasciitis are two distinct conditions that cause heel pain, but they have different underlying causes. Heel spurs are bony growths on the heel bone, which may or may not cause pain depending on their size and location.

On the other hand, plantar fasciitis involves inflammation of the plantar fascia ligament, which often results in sharp pain in the heel.

While around half of those suffering from plantar fasciitis symptoms may also have bone spurs, it’s rare for heel spurs to cause plantar fasciitis pain. Indeed, heel spurs can occur independently of plantar fasciitis, and the opposite is also true.

Accurate diagnosis and treatment of these conditions are crucial, as neglecting plantar fasciitis and heel spurs could potentially result in chronic pain in the ankle, knee, hip, or lower back.

Overview of Plantar Fasciitis

Plantar fasciitis is a common foot condition characterized by:

• Inflammation and pain in the plantar fascia ligament, often caused by developing plantar fasciitis
• Sharp heel pain
• Stabbing pain under the arch and/or on the bottom of the foot near the heel
• Pain that worsens in the morning and after extended periods of standing, exercise, or rest

The plantar fascia is a band of tissue that connects the heel bone to the toes, acting as a shock absorber for the foot, and the plantar fascia tendon plays a crucial role in this process.

The main cause of plantar fasciitis is prolonged strain on the plantar fascia ligament, often due to factors such as tight calf muscles, flat feet, or high arches.

Plantar fasciitis is believed to be the precursor to the development of heel spurs, as the body may respond to persistent strain on the plantar fascia by creating a heel spur to offer additional support for the heel.

Overview of Heel Spurs

Heel spurs, also known as a bone spur, are calcium deposits that form on the heel bone. They are often caused by long-term strain on the plantar fascia and muscles in the foot, leading to the formation of bony growths on the heel bone.

The presence of heel spurs may or may not be accompanied by pain, which depends on their size and position.

It is estimated that one out of every ten people has a heel spur, but only one out of every twenty individuals with heel spurs experiences pain.

When heel spurs do cause discomfort, it tends to be in the form of intermittent and stabbing heel pain that is more intense in the morning. However, it is not common for individuals with bone spurs on their heels to have heel pain.

Common Causes and Risk Factors

Heel spurs and plantar fasciitis share similar risk factors, including obesity, improper footwear, and repetitive activities, but have different underlying causes. Heel spurs are caused by prolonged muscle and ligament strain, resulting in the formation of small bony growths on the heel.

In contrast, plantar fasciitis is typically caused by excessive strain on the plantar fascia ligament, often due to factors such as tight calf muscles, flat feet, or high arches.

Obesity plays a significant role in the emergence of both conditions, as an excessive amount of weight puts additional pressure on the plantar fascia in the feet, resulting in inflammation and pain.

Inappropriate footwear, particularly ones with insufficient heel or arch support or a poor fit, significantly contributes to the onset of heel spurs and plantar fasciitis. To prevent these conditions, it’s vital to wear shoes that offer adequate support and fit well.

Factors Leading to Heel Spurs

Long-term strain on the plantar fascia and muscles in the foot can lead to the formation of calcium deposits on the heel bone, which is often the cause of heel spurs.

This strain can result from damage to the ligaments and foot muscles, stretching of the plantar fascia, and tearing of the membrane that covers the heel.

Calcium deposits accumulate on the underside of the heel bone over time, often resulting from persistent stress on foot muscles and ligaments, stretching of the plantar fascia, and repeated tearing of the membrane that covers the heel bone.

Older individuals are more likely to develop heel spurs due to the decreased flexibility of the plantar fascia with age and the thinning of the heel’s protective fat pad.

Factors Leading to Plantar Fasciitis

Plantar fasciitis is commonly caused by excessive tension on the plantar fascia ligament, frequently due to conditions such as tight calf muscles, flat feet, or high arches.

Tight calf muscles can intensify the pulling sensation through the Achilles tendon, leading to heel and foot pain. Flat feet can contribute to the onset of plantar fasciitis due to the lack of arch support, resulting in excessive stretching and strain on the plantar fascia.

Orthotics that provide arch support may be beneficial in treating plantar fasciitis resulting from flat feet.

High arches can affect the development of plantar fasciitis, as they change the way weight is distributed across the foot, leading to an excessive amount of pressure on the plantar fascia.

This situation may result in inflammation and pain in the heel and foot arch, underscoring the importance of addressing these risk factors to ward off plantar fasciitis.

Diagnosing Heel Spurs and Plantar Fasciitis

Diagnosing heel spurs and plantar fasciitis involves a clinical examination, imaging tests, and a thorough evaluation of symptoms and risk factors.

X-rays are the most frequently employed imaging test to diagnose plantar fasciitis and heel pain, while an MRI scan may be utilized if the heel pain is not alleviated by initial treatment methods or if the doctor has concerns about a distinct problem causing the heel pain.

During diagnosis, medical professionals usually assess the following symptoms:

• Heel pain that’s more noticeable in the morning or after long periods of rest
• Pain that intensifies with physical activity
• Tenderness or inflammation in the heel
• Challenges when walking or standing for lengthy durations

A comprehensive understanding of these symptoms and risk factors can help accurately diagnose and treat heel spurs and plantar fasciitis.

Comparing Symptoms and Pain Patterns

Heel spurs and plantar fasciitis differ in pain location, timing, and sensation. Plantar fasciitis causes consistent pain in the foot arch and heel, often described as a sharp and burning sensation.

The pain is usually exacerbated in the morning and after extended periods of standing, exercise, or rest.

Conversely, heel spurs might not always trigger pain. But when they do, the pain is often intermittent, sharp, and more severe in the morning.

It’s worth noting that it’s quite rare for individuals with bone spurs on their heels to experience heel pain. Understanding these differences in pain patterns can help guide appropriate diagnosis and treatment.

Treatment Options for Heel Spurs and Plantar Fasciitis

Treatment options for heel spurs and plantar fasciitis range from non-surgical methods, such as rest, ice, and physical therapy, to surgical interventions in more severe cases.

Non-surgical treatments for both conditions include rest, ice, proper footwear, orthotics, physical therapy, and cortisone injections.

For cases where non-surgical methods have failed, surgical treatments such as gastrocnemius recession or partial plantar fascia release may be considered.

Most patients report positive outcomes after undergoing surgery, but it is advised to exhaust all non-surgical treatments prior to considering a surgical approach.

Non-Surgical Treatments

Non-surgical treatments for heel spurs and plantar fasciitis encompass:

• Rest - vital for recovery
• The use of ice to alleviate inflammation and pain
• Suitable footwear offering sufficient arch support and cushioning
• Orthotics or bespoke shoe inserts to enhance arch support and cushioning

Physical therapy is another non-surgical treatment option that can help strengthen the muscles and tendons in the foot and ankle, reducing pain and inflammation. In some cases, cortisone injections can be used to decrease inflammation and pain in the plantar fascia.

Surgical Treatments

Surgical treatments for heel spurs and plantar fasciitis are typically reserved for cases where non-surgical methods have failed.

Procedures such as gastrocnemius recession, which involves lengthening the calf muscles, and partial plantar fascia release, where a partial cut is made to alleviate tension in the tissue, may be considered.

Gastrocnemius recession has a low complication rate, but it might lead to potential issues like spinal nerve damage and calf weakness.

Therefore, it’s advisable to discuss with a medical professional to establish the optimal treatment strategy for any common foot problem.

Preventative Measures and Lifestyle Changes

Preventative measures for heel spurs and plantar fasciitis include maintaining a healthy weight to reduce the pressure on the plantar fascia, wearing supportive footwear that provides proper arch support and cushioning, and incorporating regular stretching and strengthening exercises for the feet and calves.

These exercises can improve the strength and flexibility of the foot, reduce pain and inflammation, and improve walking.

Some of the most effective exercises for preventing heel spurs and plantar fasciitis include:

• Plantar fascia massage
• Seated plantar fascia stretch
• Heel raise
• Calf stretch on a step
• Tennis ball roll
• Towel stretch
• Toe stretch
• Toe curls

Incorporating these exercises into your daily routine can help prevent the development of these painful conditions.

How Our Clinic Can Help You Manage Heel Spurs or Plantar Fasciitis

Our clinic Modern Foot Ankle excels in diagnosing and treating heel spurs and plantar fasciitis, providing tailored treatment plans and expert advice to help you control and relieve your heel pain. We provide a comprehensive range of services, including:

• Injections
• Extracorporeal shock wave therapy
• The Tenex procedure
• Rest
• Cold packs
• Friction massage
• Custom orthotics
• Surgical options if needed

In addition to evidence-based interventions such as plantar fascia stretching and low dye taping, we also provide personalized education to patients with untreated plantar fasciitis and may suggest custom orthotics or arch supports to provide proper foot support and alignment.

Physical therapy and manual therapy techniques may also be incorporated into the treatment plan.

Contact us today for more information and take the first step towards pain-free living.

Summary

In conclusion, understanding the differences between heel spurs and plantar fasciitis is crucial for accurate diagnosis and advance treatment. Both conditions share similar risk factors but have different underlying causes and pain patterns.

A range of non-surgical and surgical treatment options is available, and preventative measures, such as maintaining a healthy weight, wearing supportive footwear, and regular stretching and strengthening exercises, can help keep heel pain at bay.

If you’re experiencing heel pain, don’t hesitate to seek professional help – our clinic MFA is here to provide personalized treatment plans and expert guidance to help you manage and alleviate your discomfort.