How to tell difference between heel spur and plantar fasciitis?

Answered by John Hunt

To differentiate between a heel spur and plantar fasciitis, it is essential to understand the characteristics and symptoms of each condition. While both can cause heel pain, there are distinct differences in their causes and manifestations.

Plantar fasciitis is a condition that occurs when the plantar fascia tendon, a thick band of tissue that connects the heel bone to the toes, becomes tight, strained, or inflamed. This can result from excessive pressure, repetitive stress, or overuse of the foot. Common causes of plantar fasciitis include wearing improper footwear, engaging in activities that put stress on the feet (such as running or jumping), having tight calf muscles, or having high arches or flat feet.

The primary symptom of plantar fasciitis is heel pain, typically felt as a sharp or stabbing sensation near the bottom of the heel. The pain is often worse in the morning or after periods of rest, as the plantar fascia tightens during inactivity. It may also be aggravated by prolonged standing, walking, or running. The pain is usually localized to the underside of the heel but can sometimes extend along the arch of the foot.

On the other hand, a heel spur is a bony protrusion that forms on the underside of the heel bone (calcaneus). It is often caused by long-term plantar fasciitis, as the body attempts to repair the damaged tissue by depositing calcium. However, it is important to note that not all individuals with plantar fasciitis develop heel spurs, and not all individuals with heel spurs experience significant pain.

Heel spurs themselves do not usually cause pain unless they come into direct contact with nerves or other sensitive structures in the foot. In such cases, the pain may be described as a deep ache or throbbing sensation in the heel. However, it is crucial to remember that the presence of a heel spur does not necessarily mean that it is the sole cause of the pain. Plantar fasciitis can still be the underlying issue, with the heel spur being an incidental finding.

To accurately diagnose the cause of heel pain, it is recommended to consult a healthcare professional, such as a podiatrist or orthopedic specialist. They will conduct a thorough examination, which may include a physical assessment, medical history review, and potentially imaging tests like X-rays or ultrasound. These diagnostic tools can help determine whether the pain is primarily due to plantar fasciitis, a heel spur, or a combination of both.

While both plantar fasciitis and heel spurs can cause heel pain, plantar fasciitis is characterized by inflammation and tightness of the plantar fascia tendon, while a heel spur is a bony protrusion that can develop as a result of long-term plantar fasciitis. It is important to seek professional medical advice for an accurate diagnosis and appropriate treatment.