Patients and doctors often confuse the terms heel spur and plantar fasciitis. While these two diagnoses are related, they are not the same. Plantar fasciitis refers to the inflammation of the plantar
fascia--the tissue that forms the arch of the foot. A heel spur is a hook of bone that can form on the heel bone (calcaneus) and is associated with plantar fasciitis. About 70 percent of patients
with plantar fasciitis have a heel spur that can be seen on an X-ray. However, many patients without symptoms of pain can have a heel spur. The exact relationship between plantar fasciitis and heel
spurs is not entirely understood.
The calcaneal spur is seen most often in persons over the age of 40. The condition can also be associated with osteoarthritis, rheumatoid arthritis, poor circulation of the blood and other
degenerative diseases. Men and women are equally likely to have them.
An individual with the lower legs turning inward, a condition called genu valgus or "knock knees," can have a tendency toward excessive pronation. This can lead to a fallen arch and problems with the
plantar fascia and heel spurs. Women tend to suffer from this condition more than men. Heel spurs can also result from an abnormally high arch. Other factors leading to heel spurs include a sudden
increase in daily activities, an increase in weight, or a thinner cushion on the bottom of the heel due to old age. A significant increase in training intensity or duration may cause inflammation of
the plantar fascia. High-heeled shoes, improperly fitted shoes, and shoes that are too flexible in the middle of the arch or bend before the toe joints will cause problems with the plantar fascia and
possibly lead to heel spurs.
A thorough history and physical exam is always necessary for the proper diagnosis of heel spurs and other foot conditions. X rays of the heel area are helpful, as excess bone production will be
Non Surgical Treatment
Some heel spurs do require surgery, however surgery is a last resort. In most cases the patients underlying foot problem needs to be addressed, such as Over Pronation and Over Supination and Heel
Pain Treatment Options need to be implemented if Plantar Fasciitis and Achilles Tendonitis are still an ongoing concern. Your best treatment is always prevention.
Sometimes bone spurs can be surgically removed or an operation to loosen the fascia, called a plantar fascia release can be performed. This surgery is about 80 percent effective in the small group of
individuals who do not have relief with conservative treatment, but symptoms may return if preventative measures (wearing proper footwear, shoe inserts, stretching, etc) are not maintained.