Plantar Fasciitis vs. Heel Spurs: Understanding the Key Differences
Medical information provided by Josh White DPM / modules.article.writtenOn July 17, 2024 Blog HomeHeel pain can interfere with your daily activities and be quite uncomfortable. Two common causes of this discomfort are plantar fasciitis and heel spurs. Although they often coexist, they are distinct conditions. Here’s a closer look at plantar fasciitis vs. heel spurs.
Introduction to plantar fasciitis and heel spurs
Plantar fasciitis is an inflammation of the plantar fascia, the thick band of connective tissue that runs along the bottom of your foot, supporting the arch and connecting your heel to your toes.
On the other hand, heel spurs are calcium deposits that form bony protrusions on the underside of the heel bone. These spurs can sometimes be seen on X-rays, though they may not always cause pain themselves [1].
Understanding the differences between plantar fasciitis vs. heel spurs is crucial for effective treatment and pain relief. And while heel spurs and plantar fasciitis usually occur together, they require different approaches for management and recovery [1].
Both conditions can significantly impact daily life, causing foot pain and discomfort that limit mobility and participation in physical activities. The pain is often described as a sharp, stabbing sensation, especially in the morning or after long periods of inactivity, which can evolve into a dull ache with continued movement [1][2].
Managing these conditions typically involves a combination of rest, stretching exercises and physical therapy, proper footwear, weight management, and, in some cases, medical interventions to alleviate pain and promote healing.
So, when you look at plantar fasciitis vs. heel spurs, you can find many similarities, but there are also differences.
What is plantar fasciitis?
We've already established that plantar fasciitis is an inflammation of the plantar fascia, the thick band of soft tissue that runs along the bottom of the foot. This foot condition, typically caused by overuse or strain, leads to sharp pain, especially noticeable in the mornings.
What are heel spurs?
Heel spurs, as mentioned earlier, are bony protrusions caused by calcium deposits building up on the underside of the heel bone over several months. They are often associated with plantar fasciitis, but don't directly cause foot pain in all cases. When they do cause pain, it's often linked to the inflammation associated with plantar fasciitis [1].
Symptoms and causes: heel spur versus plantar fasciitis
Symptoms and causes of plantar fasciitis
The soft tissue called the plantar fascia absorbs high stresses during activities like walking, running, and sports. Excessive pressure can damage or tear the plantar fascia, leading to inflammation and heel pain [1].
Risk factors for plantar fasciitis include:
- New or increased physical activity
- Shoes that don’t fit well and lack support and cushioning
- Repetitive high-impact activities such as running or dancing
- Prolonged standing on hard surfaces
- Anatomical issues like flat feet or high arches
- Tight calf muscles
- Obesity
- Age (most common in people aged 40 to 60) [2]
Symptoms typically include pain on the bottom of the foot near the heel, which is most severe with the first few steps after getting out of bed or after a long period of rest. Plantar Fasciitis pain often decreases after a few minutes of walking but may return after prolonged activity [1].
Symptoms and causes of heel spurs
Heel spurs typically result from strains on foot muscles and ligaments, stretching of the plantar fascia, and repeated tearing of the membrane that covers the heel bone. Athletes who run and jump frequently are particularly susceptible to heel spurs [2].
Risk factors for heel spurs include:
- Abnormal walking gait
- Running or jogging on hard surfaces
- Poorly fitted shoes lacking proper arch support
- Excess weight and obesity.
Additional factors associated with plantar fasciitis, such as increasing age, diabetes, prolonged standing, and having flat feet or high arches, also contribute to the development of heel spurs [2].
Heel spur versus plantar fasciitis: diagnosis and treatment options
Doctors diagnose plantar fasciitis and heel spurs primarily through a combination of medical history review and physical examination.
During the examination, doctors look for specific signs such as a high arch or flat foot, areas of maximum tenderness on the bottom of the foot just in front of the heel bone, and limited dorsiflexion in the ankle [2].
To diagnose plantar fasciitis, doctors perform a physical examination that often includes direct pressing (palpation) of the inner part of the heel bone, known as the medial calcaneal tubercle, which usually causes severe pain if the foot condition is present. This pain is generally localized at the origin of the central band of the plantar fascia, without significant pain on compression of the heel bone from side to side [3].
Additionally, doctors ensure that symptoms are not due to other conditions such as Achilles tendinitis, calcaneal stress fractures, or plantar nerve entrapment [2].
Imaging tests can also be used in the diagnosis. X-rays are commonly used to rule out other causes of heel pain, such as fractures or arthritis, and they can also reveal heel spurs, which may develop due to prolonged tension on the insertion of the plantar fascia [2].
However, since heel spurs do not directly cause plantar fasciitis pain, removing them is usually unnecessary for treating plantar fasciitis. In rare cases, if initial treatments fail or if there is concern about other potential issues, an MRI may be ordered [2].
Non-surgical treatments
- Rest and ice
Resting the affected foot and applying ice can help reduce inflammation and pain [2].
- Anti-Inflammatory medications
Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can alleviate pain and inflammation [2].
- Physical Therapy
Performing calf muscle and plantar fasciitis exercises is critical. Physical therapists may also use techniques like ultrasound therapy to promote healing [2].
- Orthotics and supportive shoes
Custom orthotic devices and shoes with
specialized insoles for plantar fasciitis and extra cushioning provide additional arch support and cushioning, helping to distribute pressure more evenly across the foot [2].
- Night splints
A night splint stretches the plantar fascia while you sleep, reducing heel pain. Though initially uncomfortable, night splints are highly effective for treating plantar fasciitis [2].
As you go through the recovery process, be sure to look out for key signs plantar fasciitis is healing to make sure your recovery process is working as intended.
Surgical treatment options
For severe cases that do not respond to non-surgical treatments, surgery may be considered. Surgical options include:
This procedure involves cutting a part of the plantar fascia ligament to relieve tension and inflammation [2].
Although heel spurs are not the direct cause of plantar fasciitis, in some cases, they may be removed during surgery if they contribute to the patient's discomfort [2].
Prevention strategies
Proper footwear
Choose shoes with built-in arch support to prevent over-pulling on the heel bone insertion, reduce arch drop, and minimize tension on the plantar fascia. Shoes with support for the inner arch (medial longitudinal arch) and metatarsal pads can be particularly effective for both prevention and treatment of plantar fasciitis [1].
Ensure your shoes have excellent cushioning to absorb impact and distribute pressure evenly across the foot. Materials like memory foam conform to your foot’s contours and reduce strain on the plantar fascia, which is crucial for preventing both plantar fasciitis and heel spurs [4].
Wear shoes that fit correctly, avoiding those that are too short or too tight, as improper fit can negatively impact the big toe joint function and damage the plantar fascia. Shoes with extra depth and width for toe movement and flexible upper materials are ideal [4].
Consider our specially designed options to ensure you're choosing the best footwear for plantar fasciitis prevention and treatment. Our plantar fasciitis shoes for women and plantar fasciitis shoes for men offer the essential arch support and cushioning needed to protect your feet. These shoes are not only effective in managing symptoms but also stylish, blending functionality with modern design.
Stretching and warm-up techniques
Regular stretching and warm-up exercises are essential in preventing plantar fasciitis and heel spurs. Plantar fascia-specific stretching significantly reduces or eliminates heel pain and is beneficial for treating chronic heel pain.
Warm-up exercises help to prepare your muscles and fascia for activity, reducing the risk of injury [1][4].
Physical activity
Avoid sudden spikes in physical activity to prevent overloading the plantar fascia. Start with low-impact exercises and gradually increase the intensity and duration by no more than 10% per week. Consistent warm-up routines and specific stretches for the feet and calves can improve flexibility and support.
Listening to your body and incorporating rest periods between high-impact activities are also crucial for preventing overuse injuries [2].
Healthy body weight
Maintaining a healthy weight reduces stress on the arches and ensures proper foot mechanics. Extra weight puts more pressure on the feet, leading to inflammation and pain in the plantar fascia. By keeping your weight in check, you minimize the strain on your feet, helping to prevent plantar fasciitis
Conclusion: Taking Steps Towards Better Foot Health
Overall, understanding the distinctions between plantar fasciitis and heel spurs is crucial for effectively managing heel pain. By staying informed and proactive about foot health, you can take significant strides toward maintaining comfort and mobility. Enhance your care by getting plantar fasciitis shoes at Orthofeet, designed to provide targeted support and relief.
References
- Rick Ansorge. Heel Spurs and Plantar Fasciitis. WebMD. August 28, 2022. Accessed June 19, 2024. https://www.webmd.com/pain-management/heel-spurs-pain-causes-symptoms-treatments
- American Academy of Orthopaedic Surgeons. Plantar Fasciitis and Bone Spurs. OrthoInfo website. Last reviewed in August 2022. Accessed June 19, 2024. https://orthoinfo.aaos.org/en/diseases--conditions/plantar-fasciitis-and-bone-spurs/
- Stephen L. Barrett, DPM., Robert O'malley, DPM. Plantar Fasciitis and Other Causes of Heel Pain. American Family Physician. April 15, 1999. Accessed June 19, 2024. https://www.aafp.org/pubs/afp/issues/1999/0415/p2200.html
- Umar Haddaya, Idrees Wajeeha, Umar Wardah, Khalil Anish, Rizvi Zuhair A. Impact of Routine Footwear on Foot Health: A Study on Plantar Fasciitis. Journal of Family Medicine and Primary Care. July 2022. Accessed June 18, 2024. https://journals.lww.com/jfmpc/fulltext/2022/07000/impact_of_routine_footwear_on_foot_health__a_study.74.aspx.