Heel Spur vs. Plantar Fasciitis: Key Differences, Symptoms, and Treatment Options

Heel pain is one of the most common complaints we see at Foot & Ankle Specialists (FAS) The Woodlands, and two of the top culprits are heel spurs and plantar fasciitis. While the symptoms often overlap, these conditions are not the same. Understanding the differences between a heel spur vs plantar fasciitis can help you take the right steps toward relief and avoid unnecessary pain or ineffective treatment. 

In this blog, we’ll break down what sets these conditions apart, how to recognize the symptoms of each, and which treatment options offer the most effective path to healing. 

Heel Spur vs Plantar Fasciitis: What’s the Difference? 

At first glance, heel spur or plantar fasciitis might seem like two names for the same problem but they are distinct conditions. 

• Plantar Fasciitis is an inflammation of the plantar fascia, the thick band of connective tissue that runs along the bottom of your foot, connecting the heel bone to the toes. 

• Heel Spurs are bony growths (calcium deposits) that form on the underside of the heel bone. These typically develop in response to long-term strain on foot muscles and ligaments, often due to chronic plantar fasciitis. 

In other words, plantar fasciitis is a soft tissue issue, while a heel spur is a bone issue. They can occur together or independently, but plantar fasciitis is much more common. 

What Causes Each Condition? 

Causes of Plantar Fasciitis: 

• Overuse from running, walking, or standing for extended periods. 

• Flat feet or high arches. 

• Poorly supportive footwear. 

• Tight calf muscles or Achilles tendon. 

• Weight gain or obesity. 

To explore these causes in more detail, visit our blog on what causes plantar fasciitis and how we treat it. 

Causes of Heel Spurs: 

• Long-term strain on foot muscles and ligaments. 

• Repetitive stress that causes the plantar fascia to pull on the heel bone. 

• Abnormal gait or foot mechanics. 

• Poor arch support. 

• Chronic plantar fasciitis. 

It’s worth noting that heel spurs are often the result of untreated plantar fasciitis, but not all patients with plantar fasciitis go on to develop a heel spur. 

Symptoms: Heel Spur vs Plantar Fasciitis 

Recognizing the symptoms of heel spur vs plantar fasciitis’ symptoms can help point you in the right direction for diagnosis and treatment. 

Plantar Fasciitis Symptoms: 

• Sharp, stabbing pain at the bottom of the heel. 

• Pain is typically worst with the first steps in the morning or after periods of rest. 

• Discomfort may improve slightly during activity but worsens again afterward. 

• Tenderness along the arch or heel. 

Heel Spur Symptoms: 

• Localized pain in the heel, especially when standing for long periods. 

• Pain that feels like a small stone or bruise under the heel. 

• May be present even without movement (not tied to first steps). 

• Often chronic and persistent. 

Only an X-ray can confirm the presence of a heel spur, as many people with heel spurs experience no symptoms at all. 

Treatment Options for Heel Spur vs Plantar Fasciitis 

Fortunately, both conditions can often be treated with conservative, non-surgical methods. Here's a breakdown of common treatments that help relieve pain and promote healing: 

1. Custom Orthotics

Supportive, custom-fit shoe inserts help correct foot mechanics, relieve pressure, and support the arch. They’re especially beneficial for patients with flat feet, high arches, or recurring plantar fasciitis. Learn more in our blog on custom orthotics vs. over-the-counter insoles. 

2. Night Splints

Wearing a splint at night keeps the foot in a stretched position while you sleep, reducing morning heel pain by preventing overnight tightening of the plantar fascia. 

3. Physical Therapy

Targeted exercises and stretches help strengthen foot muscles, improve flexibility, and reduce tension in the fascia and Achilles tendon. For specific techniques you can try at home, check out our guide on stretching exercises to relieve plantar fasciitis pain. 

4. Footwear Modifications

Shoes with proper arch support and cushioning can significantly reduce strain on the plantar fascia and heel bone. Avoid walking barefoot on hard surfaces. 

5. Advanced Treatments (when needed)

For chronic or severe cases, options like corticosteroid injections, shockwave therapy, or regenerative medicine may be recommended. Surgery is rare and typically only considered if conservative treatments fail after several months. 

When to See a Podiatrist 

Because symptoms can be very similar, a professional diagnosis is essential. A podiatrist will perform a physical exam, assess your foot mechanics, and may order imaging such as X-rays to confirm whether your pain is from a heel spur, plantar fasciitis, or both. 

If your heel pain has lasted more than a few weeks, is worsening, or is interfering with your daily activities, it’s time to schedule a consultation. While some patients hope the pain will resolve on its own, that’s not the case. Learn more in our blog: Does heel pain go away on its own?. 

Whether you’re dealing with a sharp morning heel pain or a persistent ache throughout the day, understanding the difference between a heel spur vs plantar fasciitis is the first step toward relief. At Foot & Ankle Specialists (FAS) The Woodlands, we’re here to help you, Schedule your appointment with us today to receive a personalized treatment plan tailored to your needs