Heel pain is one of the most common conditions that can lead to debilitating pain in our feet. Often, after presentation with this problem to a physician, the diagnosis of heel spurs is made. While the diagnosis of heel spur is correct, it is only part of the story.
What are heel spurs?
Heel spurs are enlargements of the heel bone that become larger with time due to tightness of our plantar fascial band. The plantar fascia is a tight band, like a ligament, that runs along the bottom of our feet, extending from the bottom of the heel all the way to our toes. This band is responsible for creating stability in our feet, and when overly tight or injured can leads to the formation of heel spurs. For most patients presenting with heel pain, the pain is not caused by the spur, but instead is caused by the tight plantar fascial band (plantar fasciitis). Heel spurs are merely a consequence of prolonged tightness of the plantar fascia.
Seventy percent of patients with plantar fasciitis have a heel spur and the majority of those have their symptoms eliminated with conservative care, without addressing the spur as the cause, or attempting surgery to remove spur.
Plantar Fasciitis symptoms
- Pain after rest (post-static dyskinesia) – the plantar fascia is painful due to tears and contracture, when we rest it can tighten and become more painful.
- Pain typically reduces with stretching or activity as band tightness reduces.
Heel Spur symptoms
- Pain worsens with activity - think of a heel spur like having the pain of walking on a stone or having a broken bone. Typically pain worsens through the day and is better with rest.
How does one diagnose this condition?
In the rare case that your pain originates from the spur, diagnosis can be made with x-rays that may show fracture of the spur or excessive formation of bone. In most cases immobilization, padding, inserts, or orthotics alleviate symptoms and only rarely do spurs need to be removed surgically.
Come see a podiatrist if you are affected by heel pain, because the treatments for plantar fasciitis and heel spur problems differ, and the right course of treatment can make all the difference in getting you pain free.