If your day has ever started with a bothersome pain at the bottom of the heel upon taking your first few steps, you probably wanted to know what was causing it. Heel spurs and plantar fasciitis are two terms frequently used when discussing this type of heel pain. For one reason or another, there are some misconceptions about how these conditions are connected.
The main problem is a false belief many people have that heel spurs are a common cause of heel pain. The truth is that while heel spurs might be associated with pain, they are usually not the reason it occurs. Instead, the majority of the time, plantar fasciitis is the responsible party when heel pain strikes.
What is Plantar Fasciitis?
The plantar fascia is a thick, connective band of soft tissue that stretches from the heel to the base of your toes. As a ligament, it connects the bones in these two areas and it’s designed to absorb the high amount of stress we place on our feet. The plantar fascia is strong and can withstand a great deal of force, but too much pressure can damage or tear it.
The body responds to this damage by becoming inflamed, and inflammation of the plantar fascia is called plantar fasciitis. As the most common cause of heel pain, plantar fasciitis affects about two million people every year.
Plantar fasciitis is usually described as a stabbing pain under the arch and/or on the bottom of the foot near the heel. This pain tends to be worse in the morning and after long periods of standing, exercise, or rest. There may also be some redness and swelling in the area.
What is a Heel Spur?
A heel spur is a calcium deposit on the bottom of the heel, where the plantar fascia inserts into the heel bone. These small, jagged bumps of bone usually develop in response to lots of trauma—or damage—to the heel. This means that in most cases, heel spurs actually form as a result of plantar fasciitis. If the plantar fascia continues to be damaged for a long period of time, the body will eventually create a heel spur to provide additional support for the heel.
Heel spurs are associated with a similar stabbing type of sensation in the heel that is usually worse in the morning and comes and goes throughout the day. But the major difference here is that the heel spur itself is rarely the actual cause of this pain. In fact, about 10% of the population has heel spurs whether they know it or not, but only 5% of those with spurs will have heel pain. The true reason for pain in most of these individuals, as you might have guessed, is plantar fasciitis.
Heel Spurs vs. Plantar Fasciitis: Exploring the Similarities and Differences
Here is one of the easiest ways to remember how these two conditions are different: many people have heel spurs without plantar fasciitis or heel pain, but it’s rare to find someone with plantar fasciitis who does not have a heel spur. Since about 1 in 10 people would show a heel spur on an X-ray of their foot, they are only considered an incidental—or insignificant—finding unless there is also foot pain.
Since both plantar fasciitis and heel spurs result from a similar process, the risk factors associated with them are shared in common. The following factors increase the chances of developing both conditions:
- Having tight calf muscles
- Being extremely overweight or obese
- Wearing shoes that are worn out, don’t fit well, or lack proper support
- Having either flat feet, high arches, or an abnormal walking pattern
- Spending too much time on your feet
- Being involved in a sport or activity with lots or running or jumping
- Increasing physical activity levels too rapidly
It’s also important to point out that although the symptoms of plantar fasciitis and a heel spur seem similar, there is one way to help tell them apart. Plantar fasciitis symptoms may be felt in the arch as well as the heel, some patients have it for a while before they notice the stabbing heel pain. In rare cases where heel spurs are responsible, the jabbing pain will be centered in the heel.
Treating Both Conditions with the Same Type of Approach
If you’re experiencing heel pain, your doctor will examine your foot and may recommend an X-ray to confirm the diagnosis. Although plantar fasciitis is the most common cause of heel pain, it’s important to rule out other causes like Achilles tendinitis, stress fractures, a broken heel, or tarsal tunnel syndrome.
With a diagnosis of either plantar fasciitis or a heel spur, nonsurgical treatments are always recommended first and are usually successful. These include:
- Rest, ice, and pain relievers – When heel pain strikes, the first thing you should do is decrease or stop any activities that might be making the pain worse, and try icing the bottom of your foot with a frozen water bottle for about 20 minutes 3-4 times per day. Pain-relieving medications like ibuprofen or acetaminophen may also help alleviate your pain temporarily.
- Change your footwear – Make sure all of your footwear fits well, is not worn out, and provides sufficient support for your feet, and try to reduce or eliminate your time in high heels.
- Arch support insoles – Tread Labs offers three types of orthotic insoles, each of which is designed to provide extra support for your aches and reduce the pressure on the plantar fascia. Wearing these insoles regularly will help to both relieve heel pain from plantar fasciitis and prevent it from returning.
- Physical therapy – Physical therapy is one of the most commonly used treatments for heel pain. Treatment usually consists of stretching both the calves and plantar fascia thoroughly, as well as manual—or hands-on—techniques performed by the therapist.
- Cortisone injections – If none of these treatments reduce pain levels, your doctor may suggest trying an injection of a steroid hormone called cortisone for additional pain relief.
For patients whose pain doesn’t improve after 6-12 months of trying these nonsurgical treatments, surgery may be considered. Surgical options for these conditions usually include gastrocnemius recession of a calf muscle and plantar fascia release.
Walk Better. Feel Better. Live Better.
The good news is that more than 90% of patients with plantar fasciitis will improve in less than 10 months after following these simple nonsurgical treatments. On the other hand, allowing the pain to persist or trying to push through it will only make matters worse and can lead to bigger foot problems.
The choice is yours, and we encourage you to make the right one. Take charge of your heel pain by following some basic suggestions, and you’ll soon experience more mobility and more freedom as your heel pain gradually fades away.