Heel pain can be frustrating and debilitating, especially if you're active or on your feet for long hours. Two of the most common causes of heel pain are plantar fasciitis and heel spurs. While they share similar symptoms, they are distinct conditions requiring different treatments. Understanding the difference between plantar fasciitis and heel spurs can help you find the most effective relief and prevent future discomfort.

What Is Plantar Fasciitis?

Plantar fasciitis is due to degenerative changes to the plantar fascia, a thick band of tissue that runs along the bottom of your foot, connecting your heel to your toes. This condition is thought to be due to excessive strain or stress on the fascia, leading to tiny tears and pain [Trojian & Tucker, 2019; Goff & Crawford, 2011; Thomas et al, 2010].

Symptoms of Plantar Fasciitis:

• Sharp or stabbing pain in the heel, especially in the morning or after periods of rest
• Pain that improves with movement but worsens after prolonged standing or walking
• Tenderness along the bottom of the foot, particularly near the heel

Common Causes of Plantar Fasciitis:

• Overuse from running or standing for long periods
• Wearing unsupportive footwear
• High arches or flat feet
• Tight calf muscles or Achilles tendon
• Excess body weight

What Is a Heel Spur?

A heel spur is a bony growth (calcium deposit) that develops on the bottom of the heel bone due to long-term strain on the plantar fascia or Achilles tendon. Heel spurs often develop as a response to chronic plantar fasciitis, but they do not always cause pain [Thomas et al, 2010; Kirkpatrick et al, 2017; Kumai & Benjamin, 2002].

Symptoms of Heel Spurs:

• Heel spurs form as a response to chronic tension on the heel bone.
  
• Often patient will experience no symptoms at all—heel spurs can exist without causing pain.
• In symptomatic cases, the pain is though to be due to the plantar fascia and not the bony spur. In these cases, patients report similar symptoms to plantar fasciitis
  

Common Causes of Heel Spurs:

• Chronic plantar fasciitis
• Repetitive stress from running or jumping
• Poor foot mechanics (flat feet or high arches)
• Ill-fitting or unsupportive shoes

Plantar Fasciitis vs. Heel Spurs: Key Differences

How to Treat and Prevent Heel Pain?

1. Rest and Reduce Inflammation

• Avoid activities that worsen the pain, like running on hard surfaces.
• Apply ice packs to the affected area for 15–20 minutes several times a day.

2. Stretch and Strengthen Your Feet

• Calf stretches: Stand against a wall with one foot forward and gently press forward to stretch the back leg.
• Plantar fascia stretch: Sit down, cross one foot over your knee, and pull your toes back gently.
• Foot strengthening exercises: Use a towel to scrunch up with your toes or pick up marbles with your feet.

3. Wear Supportive Footwear

• Choose shoes with good arch support and cushioning.
• Avoid flat shoes, high heels, or unsupportive flip-flops.

4. Use Orthotics and Heel Cushions

• Over-the-counter arch supports or custom orthotics can relieve pressure on the plantar fascia.
• Heel cups or gel inserts can reduce impact on the heel.

5. Consider Medical Interventions

If conservative treatments don’t work, a doctor may recommend:

• Physical therapy to improve foot mechanics
• Corticosteroid injections to reduce pain
• Shockwave therapy for chronic cases [Learn more about shockwaver for plantar fasciitis HERE]
• PRP for chronic cases [Learn more about PRP for plantar fasciitis HERE]
• Fasciotomy/Surgery release the plantar fascia [Learn about less invasive alternatives to surgery HERE]

When to See a Doctor

If your heel pain persists for more than a few weeks despite home treatments, it’s time to consult a specialist. A sports medicine physician can perform imaging tests like x-rays, ultrasound or MRIs to confirm the diagnosis and recommend tailored treatment options.

Final Thoughts

Plantar fasciitis can cause significant heel pain, but understanding the difference between plantar fasciitis and heel spurs is key to effective treatment. While plantar fasciitis is a painful degenerative condition, heel spurs are bony growths that often are not be painful. Most cases can be managed with proper footwear, stretching, and conservative treatments. If your pain persists, don’t hesitate to seek professional care to get back on your feet pain-free.

Need expert advice on your heel pain? Contact our sports medicine clinic today for a personalized evaluation and treatment plan!

(781) 591-7855

info@BSBortho.com

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Suite 14

Wellesley MA 02481

References:

1. Goff JD, Crawford R. Diagnosis and treatment of plantar fasciitis. Am Fam Physician. 2011 Sep 15;84(6):676-82.
   
2. Kirkpatrick J, Yassaie O, Mirjalili SA. The plantar calcaneal spur: a review of anatomy, histology, etiology and key associations. J Anat. 2017 Jun;230(6):743-751.
   
3. Kumai T, Benjamin M. Heel spur formation and the subcalcaneal enthesis of the plantar fascia. J Rheumatol. 2002 Sep;29(9):1957-64.
   
4. Schroeder BM; American College of Foot and Ankle Surgeons. American College of Foot and Ankle Surgeons: Diagnosis and treatment of heel pain. Am Fam Physician. 2002 Apr 15;65(8):1686, 1688.
   
5. Thomas JL, Christensen JC, Kravitz SR, Mendicino RW, Schuberth JM, Vanore JV, Weil LS Sr, Zlotoff HJ, Bouché R, Baker J; American College of Foot and Ankle Surgeons heel pain committee. The diagnosis and treatment of heel pain: a clinical practice guideline-revision 2010. J Foot Ankle Surg. 2010 May-Jun;49(3 Suppl):S1-19.
   
6. Trojian T, Tucker AK. Plantar Fasciitis. Am Fam Physician. 2019 Jun 15;99(12):744-750.