If you have heel pain, it can be hard to know whether it is caused by heel spurs or plantar fasciitis or something else entirely. Many times, people confuse plantar fasciitis and heel spurs, but the fact is that these two conditions are separate but can be related. For example, if you have a damaged plantar fascia tendon that goes untreated for a long while, you may develop heel spurs in your body’s misguided attempt to create heel support.
On the other hand, it is possible to have heel spurs and plantar fasciitis and have them be entirely unrelated. Even so, the pain remains the same in feeling but not in source. Pain from plantar fasciitis is caused by the strain and tightness of the tendon, itself. This causes pain at the point where the plantar fascia connects with the heel bone (calcaneous).
Pain from a heel spur is caused by a sharp, bony protrusion in the heel. It is worth noting that heel spurs do not cause pain as frequently as problems with the plantar fascia. Many people have heel spurs that never cause pain at all.
Why Does Plantar Fasciitis Hurt?
Plantar Fasciitis is caused by the ligament between your toes and heel becoming swollen, weak, and inflamed. The pain manifests as a sharp stab in the heel (hence the confusion) and is often the most severe in the morning when you get out of bed and take that first step, or after sitting for a long period of time.
When the tough ligament that runs between the calcaneous and the toes becomes weak, swollen and inflamed, it can cause sharp, stabbing pains in the heel.
The inflammation that causes this pain usually starts because of situations such as:
These pains are usually worse when you have been off your feet for a while, which is why plantar fasciitis is often called “first step pain“. You are likely to experience it as soon as you get out of bed or when you have been seated for a long time. Remembering to massage and stretch your feet a bit before putting weight on them can help with this.
What Can You Do About Plantar Fasciitis and Heel Spurs?
Luckily, it’s pretty easy to treat both of these conditions. With plantar fasciitis, a combination of physical therapy, chiropractic treatment and massage can help a great deal. Additionally, you can wear special boots while you sleep to help stretch the plantar fascia so that you will not feel a sharp pain upon arising.
Replacing incorrect footwear and shoes and boots that are in poor condition with new, well-fitted, appropriate footwear can also bring a great deal of relief. You may also wish to purchase over-the-counter (OTC) inserts and/or orthotics to provide more cushioning for your heels and support for your arches. Your doctor may recommend custom orthotic made just for you to provide exactly the support and protection your plantar fascia needs.
Exactly What Is a Heel Spur?
As we’ve noted, a heel spur can be caused by plantar fasciitis. When the ligament becomes inflamed and pulls on the calcaneous, a small, bony calcium deposit may grow in response. This situation can cause quite a bit of foot and heel pain. If that pain is actually caused by the heel spur, you may notice:
It’s hard to distinguish heel pain from plantar fascia pain, though. Even if you have the two symptoms above, your pain may be caused by the inflammation of the tendon and not by the heel spur.
How Does a Heel Spur Cause Pain?
If your heel spur is causing pain, it is because the bony growth is pressing against some other structure of the foot. You may be experiencing bone-on-bone pain, or the spur may be putting pressure on soft tissues, such as muscles or tendons. When this happens, the tissues break down and become inflamed and swollen. Having a bone spur may also cause calluses and corns to develop, and these can be painful.
How Can You Be Sure Whether You Have a Heel Spur?
A definitive diagnosis can be made by x-ray.
How Can Bone Spurs Be Treated?
With stretching, exercise and support, your plantar fascia can heal. If your plantar fasciitis has caused a bone spur, it may actually subside once the pressure that caused it has been relieved.
If the bone spur, itself, is causing pain, your doctor may recommend having it removed. Another alternative is cortisone injections, which may help ease the pain around the bone spur. Oftentimes, deep tissue massage or ultrasound therapy can be helpful.
If you have developed corns or calluses because of your bone spur, your doctor may refer you to a podiatrist for help. If you have surgery for some other foot condition (e.g. bunion surgery) your heel spurs may be removed as part of that procedure.