Is my Heel Pain a Bone Spur or Plantar Fasciitis?

Everybody – patients and doctors alike — usually confuse the terms “heel spur” and “plantar fasciitis”. Even though the two diagnoses are related, they are not the same condition. Plantar fasciitis refers to the inflammation of the plantar fascia, which is the tissue that forms the arch of your foot. In contrast, a heel spur is a hook of bone that can form on your heel bone, and is actually often associated with plantar fasciitis. About 70% of patients with plantar fasciitis have a heel spur that can be seen on an X-ray. On the other hand, many patients without symptoms of pain can have a heel spur. When it comes to a heel spur, the spur of bone usually is not the primary cause of pain. Instead, irritation and inflammation of the plantar fascia is probably the reason for the discomfort.

If you want to take care of your plantar fasciitis heel pain on your own (not recommended always see a doctor) then you should initiate a treatment plan most often prescribed by doctors, which is a stretching exercise based treatment. This includes using a night brace every night while sleeping. This is the simplest way to avoid the morning heel pain of plantar fasciitis. That is because a night brace elevates your foot while you sleep, which pre-stretches the tissues in your sole. Doing so avoids having pain in the morning.

Additional treatments include using ice, stretching, wearing proper footwear, and altering training methods.  Ice should be applied prior to and following activity for approximately 20 minutes.  Try using a frozen 12-16 oz. bottle of water and gently rolling it under your arch and heel. Your calf muscles can be stretched by standing facing a wall. Step your sore foot back and while keeping that heel down, lean forward until a comfortable pull is felt in the back of the lower leg.  Hold this stretch for 30 seconds and repeat. If you must continue training or have a job that demands prolonged walking or standing then it is essential to minimize the stresses on the heel.  Start by purchasing a pair of heel cushions.

The most important thing to remember is that no one treatment will cure your plantar fasciitis; it is a multiple therapy treatment. And it will take some time to recover fully.

The following exercises, done either with or without shoes on, can be used to help treat plantar fasciitis:

  1. Stand about 2 feet away from a wall and put both hands on the wall at shoulder height, feet slightly apart, with one foot in front of the other. Bend your front knee but keep your back knee straight and lean in towards the wall to stretch. You should feel your calf muscle tighten. Keep this position for several seconds, and then relax. Do this about 10 times then switch to the other leg. Now repeat the same exercise for both legs but this time, bring your back foot forward slightly so that your back knee is also slightly bent. Lean against the wall as before, keep the position, relax and then repeat 10 times before switching to the other leg. Repeat this routine twice a day.
  2. Stand on the bottom step of some stairs with your legs slightly apart and with your heels just off the end of the step. Hold the stair rails for support. Lower your heels, keeping your knees straight. Again you should feel the stretch in your calves. Keep the position for 20-60 seconds, and then relax. Repeat six times. Do this exercise twice a day.
  3. Sit on the floor with your legs out in front of you. Loop a towel around the ball of one of your feet. With your knee straight, pull your toes towards your nose. Hold the position for 30 seconds and repeat three times. Repeat the same exercise for the other foot. Do this once a day.
  4. Sit on a chair with your knees bent at right angles and your feet and heels flat on the floor. Lift your foot upwards, keeping your heel on the floor. Hold the position for a few seconds and then relax. Repeat about 10 times. Try to do this exercise five to six times a day.
  5. For this exercise you need an object such as a rolling pin or a drink can. While sitting in a chair, put the object under the arch of your foot. Roll the arch of your foot over the object in different directions. Perform this exercise for a few minutes for each foot at least twice a day. This exercise is best done in bare feet.

To avoid waking up in the morning with heel pain, stretching the plantar fascia with a night brace is the best way to prevent this from happening. The night brace is worn overnight and helps prevent the plantar fascia from tightening up.