Heel Spur vs Plantar Fasciitis – Similarities and Differences

Wondering how to tell the difference between a heel spur vs plantar fasciitis? You’re in the right place!

If your foot pain is interfering with your daily life, understanding what’s behind it is key to effective treatment and recovery.

It can be difficult to tell if your heel pain is a heel spur vs plantar fasciitis. But treating for one or the other without being sure which it is has the potential to make your pain worse.

Here’s a quick overview of each condition and how to tell which one you have.

Heel Spur

Heel spurs—also called plantar calcaneal spurs—are small, hook-like, bony growths that develop on the heel over time. They often occur as a result of the body healing other foot problems, like plantar fasciitis or Achilles tendonitis.

The body sometimes releases cells called osteoblasts—which repair bone—as part of the immune response to tissue damage.

When there’s repeated trauma to the foot, these bone-forming cells can cause calcium deposits to form on the heel bone.

As there’s a fatty pad on the heel, you often only notice the heel spurs when they’re advanced and you begin to feel pain in your heel.

Symptoms

The symptoms of heel spurs are often hard to detect in the beginning. You will most likely begin to notice the pain when exercising, especially when doing an activity that is moderate to high-impact.

Heel spur pain can feel like a sharp, stabbing pain in the bottom of your feet. It’s often also very noticeable when you get up after sitting for a long period.

Over time, this can develop into a dull ache that doesn’t go away. You may also find that there’s some swelling in the heel, towards the arch.

As the condition advances, you may find that you can also feel a small, bony protrusion underneath your heel. However, this is rare and you may never feel it at all.

Plantar Fasciitis

Plantar fasciitis is the most common condition that causes heel pain. It’s when the thick band of connective tissue running from your heel to the ball of your foot—the plantar fascia—becomes inflamed and painful.

It often develops due to overuse of the plantar fascia during exercise, tight calf muscles which pull on the plantar fascia, or a lack of arch support leading to overstretching of the plantar fascia.

Symptoms

The main symptom of plantar fasciitis is a sharp, stabbing pain in the heel when you get out of bed first thing in the morning.

The pain usually subsides during the day, but may occur again when you get up after a long period of sitting or resting your feet. It usually improves when exercising, although it may come back once you’ve finished your activity.

A telltale sign of plantar fasciitis is pain in the arch as well as the heel. This is because the plantar fascia helps absorb shock, but when it’s inflamed it can’t absorb shock effectively and your plantar fascia may take on more strain.

Swelling in the heel and sometimes going into the arch is often also present. As a tight plantar fascia can place stress on the Achilles tendon, you may also notice tightness in the back of your heel going up into your calf muscles.

Risk Factors for Heel Spurs and Plantar Fasciitis

The risk factors for both heel spurs and plantar fasciitis overlap. If you have any of the following, your chances of developing one or the other are increased:

Tight Calf Muscles

If your calf muscles are tight, they place more strain on the plantar fascia by keeping it under tension. As they pull, they end up stretching the plantar fascia, which can cause pain over time.

This can also increase your risk of developing heel spurs, as you are likely to change your gait and place more pressure on the heel as you walk.

Excess Weight

Your plantar fascia absorbs shock as you walk. The more weight you carry, the more stress will be on the arch of your foot, as well as the more impact on your heel.

Incorrect Shoes

Wearing shoes that don’t offer enough arch support can lead to both heel spurs and plantar fasciitis. Also, shoes with minimal cushioning won’t absorb shock effectively, which can aggravate both conditions. So it’s key to wear good shoes for plantar fasciitis or heel spurs.

Foot Structure or Gait

If you have flat feet or high arches, you’re more likely to suffer from plantar fasciitis or heel spurs due to excess strain on certain parts of the foot due to a compromised gait.

Repetitive or Sudden Strain

Repetitive strain on the foot can lead to overuse injuries, and sudden strain can trigger an acute injury. Both of these types of injury can lead to plantar fasciitis or heel spurs as they heal.

This can be made worse by a sudden increase in either frequency or intensity of your exercise.

What Are the Similarities Between Heel Spurs and Plantar Fasciitis?

Heel spurs and plantar fasciitis present quite similarly in some ways. Here are the biggest similarities between the two conditions.

Heel Pain

This is most likely the reason you’re reading this article in the first place! Heel pain is the biggest sign of both conditions, and probably the first one that you’ll notice.

It can be sharp, and shooting or a dull ache, depending on the time of day and your activity.

Swelling

You’re likely to also experience swelling under the heel and sometimes also under the arch with both of these foot conditions. This is due to the inflammation in the foot and may be accompanied by redness and warmth.

Causes & Risk Factors

The causes and risk factors of plantar fasciitis and heel spurs are extremely similar. Trying to diagnose yourself with one or the other based on the underlying reason is almost impossible.

What’s the Difference Between Heel Spurs and Plantar Fasciitis?

While the similarities are good to know, the differences between a heel spur vs plantar fasciitis is the most important part. Here are the biggest differences.

Location of the Pain

While both of these conditions present with pain in the heel, the location is slightly different. If the pain is centered underneath the heel, it’s more likely to be heel spurs.

But if it’s right on the bottom of the heel bone, where the plantar fascia connects to the Achilles tendon, it’s more likely to be plantar fasciitis.

When you have plantar fasciitis, you’re also quite likely to experience pain in the arch of your foot, which doesn’t happen with heel spurs.

Nature of the Pain

When you have heel spurs, the pain tends to be unaffected by activity. But plantar fasciitis pain reduces during exercise and increases when inactive. It also presents as worse in the morning.

Heel Spur vs Plantar Fasciitis: Quick Symptom Checker

The easiest way to tell if you have a heel spur vs plantar fasciitis is to answer a few quick and easy questions about your symptoms!

Where Is Your Pain?

  • Center of heel: Heel spurs
  • Bottom of heel bone: Plantar fasciitis

Do You Have Arch Pain?

  • No: Heel spurs
  • Yes: Plantar fasciitis

Is Your Achilles Tendon Also Painful/Inflamed?

  • No: Heel spurs
  • Yes: Plantar fasciitis

Does The Pain Get Worse With Exercise?

  • Yes: Heel spurs
  • No: Plantar fasciitis

Final Thoughts

Even if you find that diagnosing your condition is easier with these questions, we highly advise visiting your doctor just to be sure.

You should also consider making small changes like getting new shoes—depending on whether you have plantar fasciitis or heel spurs—getting an insole, and stretching your feet regularly.

Buchanan, Benjamin K., and Donald Kushner. “Plantar Fasciitis.” PubMed, StatPearls Publishing, 2020,
www.ncbi.nlm.nih.gov/books/NBK431073/ 

Kirkpatrick, Joshua, et al. “The Plantar Calcaneal Spur: A Review of Anatomy, Histology, Etiology and Key Associations.” Journal of Anatomy, vol. 230, no. 6, 29 Mar. 2017, pp. 743–751,
www.ncbi.nlm.nih.gov/pmc/articles/PMC5442149/, 10.1111/joa.12607 

Pan, Weiyi, et al. “Elasticity of the Achilles Tendon in Individuals with and without Plantar Fasciitis: A Shear Wave Elastography Study.” Frontiers in Physiology, vol. 12, 21 June 2021,
www.frontiersin.org/articles/10.3389/fphys.2021.686631/full 10.3389/fphys.2021.686631 

The Editors of Encyclopedia Britannica. “Osteoblast | Cell.” Encyclopædia Britannica, 15 Nov. 2018,
www.britannica.com/science/osteoblast