One of the most common questions asked about heel pain and plantar fasciitis is whether or not it is the same thing as heel spurs, so here’s a breakdown of what each of these issues are and how they are related to one another.
When we break down the words plantar fasciitis this is what we get:
Plantar: bottom of the foot + Fascia: connective tissue + Itis: inflammation = plantar fasciitis, which is pronounced PLAN-tar fashee-EYE-tiss.
Therefore, the medical definition of this condition applies only when there is “bottom of the foot connective tissue inflammation”; this term does not include heel spurs, so right away we know that we are dealing with two separate issues.
So that leaves the question of what exactly Heel Spurs are then if they are not one and the same as plantar fasciitis. Heel spurs are also often referred to as ‘calcaneal’ spurs, which are soft, bendable calcium deposits that develop on the heel. It is often assumed that heel spurs are shards of bone that cause pain by poking into surrounding tissues, but this simply isn’t true; heel spurs are bendable calcium growths that rarely ever cause pain on their own.
There is so much confusion with these who conditions because heel spurs are one of the primary indicators of the presence of plantar fasciitis; rarely, if ever, are heel spurs seen a foot that is not already suffering from inflammation of the plantar fascia.
Characteristics of Heel Pain and Plantar Fasciitis
Plantar fasciitis is the inflammation of the plantar fascia, the thick band of tissue that covers the muscle that connects the ball of the foot to the heel of the foot by way of our arches.
Our fascia is under a massive amount of tension and pressure: the moment our heel lifts off the ground it must endure more than twice our body weight, minimum. If we are carrying excess weight or we have tight or inflexible calf muscles than this tension will increase accordingly. This means that if we increase our body weight by 3% then the tension placed on our plantar fascia increases by 3% as well.
Plantar fasciitis occurs when there is a thickening of the plantar fascia from chronic or acute inflammation of these tissues, and while heel spurs are common companions of this type of affliction they need not be present for diagnosis. The issue is further confused by the fact that pain is quite often present, and may only be present, in the heel of the foot. Although it is possible to have plantar fasciitis without discomfort in the heel or the feet this situation tends to be rare.
This particular affliction of the foot is common because it is easily caused by daily activities that require repetitive motion, such as walking and climbing stairs. The risk of developing inflammation is also increased if you have tight calf muscles or if you are overweight.
Primary treatments of plantar fasciitis (heel spurs) include cessation of activities, applying ice to the afflicted areas, and gently stretching the muscles on a regular basis. Surgery is often used only as a last resort as it is not always effective and can cause problems on its own.
Generally speaking, 12 to 36 hours must pass before pain symptoms hit their peak, and this makes is very difficult to pinpoint the exact cause of the inflammation. For instance, the onset of pain takes so much time to develop that a runner will not be able to tell if it was mounting the last hill or simply going to many miles that caused discomfort because the pain will not occur immediately after the activity is completed.
Pain symptoms caused by plantar fasciitis (heel spurs) can range from mildly irritating to absolutely debilitating. To confuse the issue even more the pain can be constant or it may come and go over a period of days or even months. Plantar fasciitis and heel spurs are most often caused by how we approach certain activities, as opposed to the activities themselves. For example, walking is good for us but excessive walking on unforgiving surfaces with old shoes that lack support may create painful injuries of inflammation and irritation in our feet.
Heel Spurs and Plantar Fasciitis
Heel spurs and plantar fasciitis are often referred to interchangeably simply because the primary symptom of plantar fasciitis is heel pain; not to mention that if you have a heel spur then you almost certainly have plantar fasciitis. In fact, heel pain is such a prevalent symptom, (particularly when it’s at its worst first thing in the morning) that when it doesn’t occur the diagnosis is often re-evaluated.
Although plantar fasciitis is made worse when pressure is increased at the front of the foot many sufferers will begin walking more ‘on the toe’ because of the discomfort they experience when the heel makes contact with the ground. Unfortunately, this puts the plantar fascia under much more pressure and it can seriously aggravate the situation.
Heel Pain in Children
Plantar fasciitis rarely occurs in people under 25 years of age, so when physically active children between the ages of 8 and 13 years old experience that type of heel painl they are most often suffering from Sever’s disease, which tends to occur when the heel bone of active children is still growing. Treatment of these conditions is very similar; rest and ice usually helps immediate discomfort and in the case of Sever’s disease time will eventually eliminate the problem altogether.
Common Treatments for Heel Pain
Because it can worsen current conditions and has not proven consistently effective, surgery is never the first line of treatment when dealing with plantar fasciitis. The most common and effective treatments are as follows:
1. Rest: A reduction in frequency and intensity of activity reduces the amount of tension that your plantar fascia is under. Not only will this help to prevent an increase in the level of inflammation it will also give current irritations time to heal.
2. Ice: Applying an ice pack immediately after being active is a good idea if you are suffering from inflammation and/or irritation of the plantar fascia. Be sure to wrap your ice/ice pack or package of frozen vegetables in a towel before applying it to your skin.
3. Stretch: The less flexible your calf muscles are the more likely it is you will suffer from plantar fasciitis, so be sure to stretch after every activity. It doesn’t hurt to make a habit of stretching throughout the day either, especially when you first wake up. If you are not physically active you should try to stretch three or four times a day anyway.
4. Tape: Correctly applied athletic tape can reduce tension on the plantar fascia and provide relief from discomfort.
5. Arch Support Orthotics: Even if you do not have flat feet providing additional support for your arches can relieve pressure and reduce inflammation and pain.
6. Lose Weight : Every pound you gain places additional stress on your joints and on your plantar fascia, so if you are carrying extra weight make losing a few pounds a priority.
Plantar fasciitis has many symptoms and causes and an equal amount of treatments, but many sufferers find relief by combining some or all of the above recommendations together and by monitoring the intensity and type of physical activity they do.
Treating plantar fasciitis can take time. Some people will respond immediately to treatment while others will take longer, but the important thing is to be patient and to keep putting treatments into practice because consistency matters. It’s also important to realize that not all treatments reduce discomfort; some of them are there to reduce inflammation and protect you from further injury.
Your pain probably occurred gradually, and it will probably diminish gradually as well. Your treatment needs to be a priority no matter how busy your days are. Stretching, taping, icing and resting may not be the most ‘fun’ or convenient activities, but they will contribute greatly to your recovery and your level of comfort, so it’s wise to invest in these strategies.
And remember; your recovery may not follow a constant arc of improvement. Some days will be better than others, but how well you deal with setbacks will affect the degree to which your pain is reduced and it will also directly affect whether your plantar fasciitis returns in the future.
Lifestyle is an important factor concerning the health of our feet; the type of decisions we make in footwear, levels of physical activity, excessive standing and running, diet etc. affect our overall health in a multitude of ways.
It really is up to us to make the healthiest, most pro-active choices possible. If you have a desk job then you generally have no choice but to spend a lot of time sitting, but it’s up to you to take enough breaks where you stand up and stretch and move around a little bit.
No matter what type of lifestyle you have, you also have choices that will either help or hinder your quest to deal with the onset, or prevention, of plantar fasciitis and heel spurs.
Now that we’ve taken a closer look at the exact nature of both plantar fasciitis and heel spurs, it should be clear that they are not the same condition although they are very clearly (and closely) linked. In fact, heel spurs are rarely seen if plantar fasciitis is not present, though it often happens that you can develop plantar fasciitis without developing heel spurs.
In most cases where heel pain is the issue it is unnecessary to differentiate between these two afflictions since they so frequently occur together and share the same treatments. It is for this reason that most doctors refer to them interchangeably, and many doctors use the term ‘heel spurs’ when talking to patients because it’s easier to understand a visible result on an x-ray than it is to picture inflamed fascia tissue cover a muscle in the foot.
Hopefully this introduction and overview to plantar fasciitis cleared up any confusion on the subject and provided you with a better understanding of this very common, and very uncomfortable, condition.