Heel Spurs and Fasciitis plantar. What is the difference?

Despite the fact that heel complaints are often referred to as ‘heel spur’ in most cases, the vast majority of people often suffer from inflammation of the tendon plate ( Fasciitis plantar ). However, ‘heel spurs’ is a widely used and well-known term, often used to describe heel pain. But what is the difference between these terms?

The Differences Between Heel Spurs and Fasciitis plantar

In this blog we will discuss the differences between Heel Spurs & Fasciitis Plantar , which means both diagnoses, the treatment of both and which tools can help you recover faster and get through the day pain-free.

The Symptoms of Heel Spurs and Fasciitis Plantar are often the same, but they are two ‘completely different’ diagnoses. The differences are mainly in the affected structures of the problem and not in the symptoms. To explain the difference between the two, let me first explain both terms to you:

What is heel spurs?

In heel spurs, a spinous appendage has developed on the heel bone due to calcification (see image below). Heel spur owes its name to the bony growth ( osteophyte ) which arises at the attachment of the tendon plate under the foot ( Fascia Plantaris ). This osteophyte bears some resemblance to the spurs as they used to be on cowboys’ boots.

The calcification that develops does not have to be a guarantee to experience pain. Many people will have a (minor) calcification without experiencing the symptoms of heel spurs.

What is Fasciitis plantar?

Fasciitis Plantar is a condition in which a non-bacterial inflammatory reaction has developed at the tendon plate (the fascia plantaris ), located on the underside of the foot (see image below). This tendon plate has its beginning (the Origo ) at the heel bone, at the place where a heel spur originates (hence the confusion with the diagnosis heel spur). plantar Fasciitis can be diagnosed by ultrasound or MRI and not by X-ray.

What is the difference?

The Differences Between Heel Spurs and Fasciitis Plantaris are therefore related to the affected structures, not so much to the symptoms (pain under the foot, starting pain, pain after standing for a long time, etc ). With a heel spur there is extra bone formation due to calcification. With a Fasciitis Plantar is an inflammation of the soft tissues (the tendon plate) that causes the complaints.

Causes

Often both Fasciitis arise Plantar as a heel spur due to a chronic overload. Well-known causes and risk factors of overload are:

• Overweight
• Flat feet
• Excessive pronation in the feet
• Stiff or short calf muscles
• Bad shoes
• Standing for a long time (e.g. with a standing profession)

Complaints

What symptoms / characteristics do people with Heel Spurs and Fasciitis give Plantar often on?

• Pain at the bottom of the foot,
• Pain during (prolonged) walking or standing
• Starting pain (pain with the first steps when you get out of bed in the morning or when you have been sitting or standing for a long time)
• A thickening of the heel cushion under the foot

How To Treat Heel Spurs?

Heel spurs are a difficult diagnosis to treat because of the change in shape of the bone. A bone cannot be influenced by conservative treatment (eg exercises). What can be treated are the surrounding structures that have been affected by ‘the Heel Track’. You can choose to treat at night, during the day or both. A night splint can be used at night to ensure that the ‘foot does not hang down’ and the tension on the tendon plate is increased. During the day you can choose to wear heel spur gel heels or heel spur soles . These provide cushioning and pressure distribution in the painful area, reducing irritation of the affected structures and pain. For optimal results, we recommend that you treat both during the day and at night. You can do this by using one of our Heel Track Packages .

How Fasciitis to treat plantar?

The Treatment Methods for Fasciitis Plantar are similar to heel spurs; a night splint for the night and insoles during the day. For Fasciitis Plantar we have special Fasciitis Plantar Insoles for sale. These provide good support for the arch of the foot and the tendon plate, to take the foot out of pronation and to prevent flat feet.

Other treatment methods for heel spurs and fasciitis plantar :

• Shockwave therapy, whereby the heel spur is pulverized with ultrasonic sound wave.
• Dry Needling , with the help of needles the internal pain points are tapped to help a healing process.
• Surgery. This is done less and less, but an (orthopedic) surgeon can surgically remove a heel spur.
• Epte (percutaneous electrolysis ). This treatment method is increasingly used and has so far achieved a lot of good practice based – results.
  

What Does a Heel Spur Night Splint Do?

A night splint ensures that the foot does not droop while sleeping. By supporting the foot at an angle of approximately 80-90 degrees, the tendon plate under the foot (plantar fascia ) will not end up in a tense / drooping position. The hanging ( plantar flexion ) of the foot is a natural position while sleeping (think of the well-known ‘Fetal position’). The tendon plate is under light tension and in a shortened position during the night. In the morning, the tendon plate is stretched again with the first steps, resulting in starting pain / muscle pain. You can remedy this starting pain by using a Heel Spur Night Splint during the night.

It is normal to have to get used to wearing a night splint. When the use is slightly built up, the habituation time is at least 14 days. After this, no more physical discomforts will be experienced. In total, the advice is to wear the splint for at least 6-8 weeks for a good effect. This effect can be supported by wearing gel heels or insoles. In most cases we recommend a night splint over a Strassburg sock . The advantage of the splint is that the toes do not come into an overextended position, which could cause cramping.

Want to know more about Heelspoor? View our heel spurs injury page