Some things just go together—to the point that it’s hard to think about one without the other. Peanut butter and jelly. Macaroni and cheese. Tom & Jerry. Shoes and socks. Plantar fasciitis and heels spurs.
Wait, what was that last one again?
Yup, plantar fasciitis and heel spurs. Let’s back up a minute and explain.
While these two heel pain conditions aren’t inseparable, exactly, they are often linked and frequently found together. And that sometimes leaves patients feeling confused about just what is really causing their heel pain.
What Is Plantar Fasciitis?
Plantar fasciitis is a condition caused by inflammation in a band of tissue known as the plantar fascia.
The plantar fascia actually runs across the entire underside of your foot, from the heel bone at one end to the toes at the other. Its primary responsibility is to support the arch of your foot.
However, when the plantar fascia is overstretched through overuse, it can start to tear and break down—and the “weak point” is usually right where the band of tissue attaches to the heel bone. That’s why pain is typically located there.
Plantar fasciitis is the most common cause of heel pain in American adults. The most common symptom is heel pain that is at its worst right when you get up—from bed, or even from a long break on a chair or couch.
What Are Heel Spurs?
In general terms, bone spurs are deposits of calcium that can build up on the surface of a bone as a response to chronic trauma.
Essentially, when you have a soft tissue injury, the inflamed ligament or tendon can start to “pull away” from the bone, leaving a partially exposed gap. If this continues for an extended period of time, your body attempts to fix the issue by forming new bone. The calcium deposits then slowly build up to fill in the space.
Most heel spurs are located along the underside of the heel bone, pointing forward. A typical heel spur reaches about a quarter of an inch in length, but the largest ones can protrude forward by up to half an inch—or sometimes more.
You usually can’t see or feel them from the outside, but heel spurs will show up on an X-ray.
So What’s the Connection?
A few of you may have already figured it out based on the descriptions we gave, but let’s make the connection clear:
In most cases, plantar fasciitis is the direct cause of heel spurs. That inflamed tissue tugs at, and pulls away from, the front of the heel bone. And if you don’t make an effort to treat your heel pain in a timely fashion, the heel spur begins to form.
How strong is this connection?
By some estimates, as much as 50-70 percent of people who have had plantar fasciitis at some point in the past have also developed heel spurs.
What Is Really Causing My Pain?
One obvious difference between plantar fasciitis and heel spurs is that, while plantar fasciitis can almost always be treated—and truly healed—through conservative treatments, heel spurs are more or less permanent. You would have to remove one surgically to get rid of it.
So that means that heel spurs are the bigger threat, and thus require more aggressive treatment if your heel pain advanced to that stage, right?
Actually, the answer is no—at least not in the majority of cases.
Yes, heel spurs can be a source of pain all on their own if they become particularly large, or form in a particularly inconvenient spot. And bone spurs in other parts of the body can be very problematic, too—those that form in arthritic joints after the cartilage has worn away can be especially painful.
But by contrast, heel spurs are usually painless. In fact, millions of Americans have them from a previous heel pain episode and don’t even know it!
More than 90 percent of the time, plantar fasciitis is the real culprit. Not only is it the cause of the spur, but it’s also probably still the main cause of any ongoing discomfort. And treating the plantar fasciitis is very likely to take away your pain even if we leave the spur alone.
Treatment for Heel Pain
If you are currently suffering with heel pain you just can’t shake, stop by our Palm Desert office to see Dr. Harvey Danciger. We offer an impressive array of treatment options to help those who are suffering from plantar fasciitis, heel spurs, or both—almost always without surgery.
Quite often, relatively simple measures are all that are needed to relieve symptoms if your pain is relatively mild to moderate. This includes options such performing specific stretching exercises, wearing splints at night, or even just switching to a more comfortable and supportive pair of shoes.
If your pain is more significant, we may recommend more advanced options, such as laser therapy to help kickstart a stalled healing process, or custom orthotics to provide support and stability for a compromised foot structure.
Again, the vast majority of the time, once we get the plantar fasciitis to subside, the pain goes away whether or not you have a heel spur. And even if there is some pain caused by the spur directly, often some of the same treatment options (like better shoes and custom orthotics) can help resolve it.
Surgery might be required only in rare cases where the pain from either condition does not respond to conservative treatment. Procedures to release a tight plantar fascia, alleviate pressure on a spur, or even remove the spur may be considered.
The best way to avoid even the small chance that surgery might be required? Don’t wait for the pain to get worse and worse and worse before you seek help! If your pain cannot be controlled with a few days of rest—and it’s starting to impact your quality of life—give us a call right away at (760) 568-0108. We can help!