The key difference between heel spurs and plantar fasciitis is that the plantar fasciitis is always associated with inflammation but a heel spur gets inflamed only when it gets traumatized.
Heel spurs, which are also known as plantar spurs, are traction lesions at the insertion of the plantar fascia. In contrast, plantar fasciitis is an enthesitis at the insertion of the tendon into the calcaneum of the foot. Heel spurs are usually associated with plantar fasciitis but may also occur alone with no other abnormalities.
CONTENTS
1. Overview and Key Difference
2. What is Heel Spurs
3. What is Plantar Fasciitis
4. Side by Side Comparison – Heel Spurs vs Plantar Fasciitis in Tabular Form
5. Summary
What are Heel Spurs?
Heel spurs are traction lesions at the insertion of plantar fascia. This is very common agmong elderly patients. However, they do not become painful unless they are traumatized. About 10% of patients with plantar fasciitis suffer from heel spurs.
Figure 01: Heel Spur in Plantar Fasciitis
The belief that heel spurs are the cause of pain in plantar fasciitis is a misconception. Surgical removal of the spur is the treatment if a heel spur becomes troublesome.
What is Plantar Fasciitis?
Plantar fasciitis is an enthesitis at the insertion of the tendon into the calcaneum of the foot. In this condition, there is an inflammation in the point of insertion of the muscle-tendon into the calcaneum. This gives rise to a moderate to severe pain in the bottom of the heel when walking and standing. The area is usually tender to touch. This condition can occur as an isolated non-complicated disease or in conjunction with generalized disease conditions such as spondyloarthritis. Too much stress and strain on the plantar fascia is believed to be the underlying pathological basis of plantar fasciitis.
Figure 02: Plantar Fasciitis
Risk Factors
- Obesity
- High arch
- Overexertion
Management
Medical Management
- Wearing specially designed footwear to prevent the exertion of an undue stress on the heel.
- Minimizing the activities that can put the plantar fascia under the stress such as repetitive exercises.
- Pain relief with analgesics
- Arresting the inflammation using anti-inflammatory drugs
Surgical Management
The failure of the symptoms to subside after one year of medical treatment is the sole indication for the surgical intervention. Plantar fascia release and gastrocnemius recession are the surgical procedures that help to control the associated inflammatory processes.
What is the Difference Between Heel Spurs and Plantar Fasciitis?
Heel spurs are traction lesions at the insertion of the plantar fascia while plantar fasciitis is an enthesitis at the insertion of the tendon into the calcaneum of the foot. Usually, there is no ongoing inflammation in heel spurs, but plantar fasciitis has an associated inflammation. This is the main difference between heel spurs and plantar fasciitis.
If a heel spurs become troublesome, you can get surgical treatment. However, treatment of plantar fasciitis includes two components as medical and surgical management.
Summary – Heel Spurs vs Plantar Fasciitis
Plantar fasciitis is always associated with an ongoing inflammatory process but heel spurs are inflamed only when the spur gets traumatized. This is the main difference between heel spurs and plantar fasciitis.
Reference:
1. Kumar, Parveen J., and Michael L. Clark. Kumar & Clark clinical medicine. Edinburgh: W.B. Saunders, 2009.
Image Courtesy:
1. “Projectional radiography of calcaneal spur” By Lucien Monfils – Own work (CC BY-SA 3.0) via Commons Wikimedia
2. “Top 5 Shoes for Heel Spurs and Plantar Fasciitis” by Daniel Max (CC BY 2.0) via Flickr