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  • Writer's pictureDr. Ndidi Ufondu, DPM

Understanding the difference between Plantar Fasciitis and heel spurs



If you suffer from heel pain, you might have heard of plantar fasciitis and heel spurs. These are two common conditions that affect the heel, but they are not the same thing. In fact, plantar fasciitis is often the cause of heel spurs, not the other way around. In this blog post, we will explain the difference between plantar fasciitis and heel spurs, and how to treat them effectively.


What is plantar fasciitis?



Plantar fasciitis is an inflammation of the plantar fascia, a thick band of tissue that runs along the bottom of your foot and connects your heel to your toes. The plantar fascia supports the arch of your foot and acts as a shock absorber when you walk, run, or do other activities.



Plantar fasciitis occurs when the plantar fascia is overstretched or damaged due to excessive stress or strain. This can happen for various reasons, such as:

  • New or increased activity

  • Repetitive high impact activity (running/dancing/sports)

  • Prolonged standing on hard surfaces (especially among nurses, factory workers, and teachers)

  • Anatomy (flat feet or a high arch)

  • Tight calf muscles

  • Obesity

  • Age (plantar fasciitis is most common among people aged 40 to 60)


When the plantar fascia is inflamed, it causes pain and stiffness in the bottom of your heel, especially in the morning or after a long period of rest. The pain may also radiate to your toes or along the arch of your foot. The pain usually improves as you warm up your foot, but it may return after exercise or activity.


What is a heel spur?


A heel spur is a type of bone spur, or calcium deposit, that grows on the back or bottom of your heel bone (calcaneus). A heel spur may look like a small hook or spike on an X-ray, but it is not always visible.


A heel spur develops as a result of long-standing damage to the plantar fascia insertion, which is where the plantar fascia attaches to the heel bone. When the plantar fascia is constantly pulled and torn by the heel bone, the body tries to repair it by laying down extra bone tissue. This creates a bony protrusion that may press on the surrounding tissues and nerves.


However, contrary to popular belief, a heel spur is not usually the cause of heel pain. In fact, many people have heel spurs without any symptoms at all. Only about 5% of people with heel spurs experience heel pain, while about 10% of people without heel spurs have heel pain.


The real culprit behind most cases of heel pain is plantar fasciitis, not a heel spur. A heel spur may only contribute to the pain if it irritates or compresses the nearby tissues or nerves.


How are plantar fasciitis and heel spurs diagnosed and treated?


To diagnose plantar fasciitis and heel spurs, your doctor will ask you about your symptoms and medical history, and examine your foot for signs of inflammation, tenderness, and limited motion. Your doctor may also order imaging tests, such as X-rays or ultrasound, to rule out other causes of heel pain and to confirm the presence of a heel spur.


The good news is that both plantar fasciitis and heel spurs can be treated successfully with conservative methods in most cases. These include:

  1. Resting your foot and avoiding activities that worsen your pain

  2. Applying ice packs to your heel for 15 to 20 minutes several times a day

  3. Taking over-the-counter anti-inflammatory medications, such as ibuprofen or naproxen

  4. Wearing supportive shoes with good cushioning and arch support

  5. Using orthotic devices or insoles that provide extra support and stability for your foot

  6. Stretching your calf muscles and plantar fascia regularly

  7. Doing physical therapy exercises to strengthen your foot muscles and improve your flexibility

  8. Wearing a night splint that keeps your foot in a stretched position while you sleep

  9. Getting corticosteroid injections into your heel to reduce inflammation and pain


In rare cases, if conservative treatments fail to provide relief after six to 12 months, surgery may be considered. Surgery may involve releasing part of the plantar fascia from the heel bone (plantar fasciotomy) or removing the heel spur (heel spur removal). However, surgery has risks and complications, such as infection, nerve damage, scarring, and recurrence of symptoms. Therefore, surgery should only be done as a last resort.


Conclusion


Plantar fasciitis and heel spurs are two different conditions that affect the heel, but they are often confused for each other. Plantar fasciitis is an inflammation of the plantar fascia, a band of tissue that supports the arch of your foot. Heel spurs are bony growths that form on the heel bone as a result of long-standing damage to the plantar fascia. Plantar fasciitis is the main cause of heel pain, while heel spurs are usually harmless and painless. Both plantar fasciitis and heel spurs can be treated effectively with non-surgical methods, such as rest, ice, medication, shoes, insoles, stretches, exercises, and injections. Surgery is rarely needed and should only be considered after exhausting all other options.

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