The difference between heel spur and plantar fasciitis
Many people with pain under the heel immediately think of a heel spur. However, this is not always the correct diagnosis. In most cases, it is plantar fasciitis, an inflammation of the tendon plate under the foot. It is important to know the difference, as this affects treatment and recovery.
What is a heel spur?
A heel spur is a small bony growth on the heel bone. It develops due to prolonged overload of the attachment of the tendon plate (plantar fascia) to the heel bone.
This calcium deposit is clearly visible on an X-ray. Remarkably, a heel spur does not always cause pain. Many people have one without noticing any symptoms.
What is plantar fasciitis?
In plantar fasciitis, the tendon plate under the foot is inflamed. This causes a sharp pain when standing up or after sitting for a long time. The first steps in the morning are often particularly painful.
The inflammation usually develops due to overuse, for example from prolonged standing, running, or flat feet. Incorrect footwear or excess body weight can also contribute to the symptoms.
The main differences
| Feature | Heel spur | Plantar fasciitis |
|---|---|---|
| Cause | Calcium deposit on the heel bone | Inflammation of the tendon plate |
| Pain location | Under the heel, often localized | Under the foot, sometimes radiating toward the forefoot |
| Moment of pain | Often during prolonged load | Especially during the first steps in the morning |
| Visible on X-ray | Yes | No |
In many cases, both conditions occur together. Plantar fasciitis can, over time, lead to a heel spur, as the body attempts to compensate for the constant pulling force at the tendon attachment site.
How do heel spur or plantar fasciitis develop?
Both conditions are caused by overuse of the foot. Possible causes include:
- Prolonged standing or walking on hard surfaces
- Poor footwear without proper cushioning
- Excess body weight
- Flat feet or high arches
- Intensive sports activities (running, jumping, hiking)
- Tight calf muscles or a shortened tendon plate
A correct diagnosis is important to address the underlying cause and prevent recurrence.
Treatment of heel spur
The treatment of a heel spur focuses on reducing pressure and tension on the heel bone. An important part of this is the use of heel spur insoles or orthotic insoles, which distribute pressure under the foot more evenly and relieve the tendon attachment area. Additionally, cooling the heel several times a day with a cold pack can help reduce inflammation.
In some cases, a physiotherapist may also apply taping or shockwave therapy to promote recovery. Furthermore, it is advisable to regularly perform stretching exercises for the calf and foot muscles, reducing tension on the tendon plate. Finally, good footwear plays a major role in recovery: sturdy shoes with a supportive footbed and a stable heel counter support the arch of the foot and help prevent symptoms from returning.
Treatment of plantar fasciitis
The treatment of plantar fasciitis is similar to that of a heel spur, but places greater emphasis on recovery of the tendon plate and reduction of inflammation. It is important to give the foot sufficient rest and temporarily reduce load so the tissue can heal. Physiotherapy can also help make the tendon plate more flexible through targeted stretching exercises and anti-inflammatory techniques.
Wearing insoles with proper arch support is also essential: they reduce tension on the tendon plate and ensure even pressure distribution under the foot. Finally, massage and cold rolling therapy can provide relief. Rolling a chilled bottle or massage ball under the foot stimulates blood circulation and reduces pain and stiffness in the tendon plate.
The effect of a heel spur night splint
A heel spur night splint keeps the foot in a slight stretch position during sleep. This keeps the tendon plate under tension overnight, preventing it from developing new “micro-tears” when getting out of bed in the morning. The result is less pain during the first steps of the day and faster recovery.
Tip: Combine a night splint with a good pair of insoles or heel spur pads for the best results.
