“I’ve got a heel spur” is hands-down one of the most common things we hear when we ask a new patient what’s brought them into the clinic. When we dig a little deeper, we often discover that this ‘diagnosis’ has been given by a well-meaning family member when they heard the patient had heel pain, a medical professional without taking any x-rays (and that often that doesn’t specialise in the complex nature of foot pain), or simply from something they’ve read online.

The truth is that heel spurs and plantar fasciitis heel pain are two very different problems, anatomically speaking, that require very different care. One thing we stand for is accurate diagnoses and not wasting your time and money treating the wrong problem – so we thought we’d clear the air today about what heel spurs are, what plantar fasciitis is, and what you should do if you have heel pain.

 

Heel spurs: The facts

A heel spur is a hard, bony outgrowth at the bottom of the heel. It can appear like a little hook that angles in towards the centre of the foot from the heel. You can get bony spurs all around your body, like the knees, shoulders and hands – not just the heel. 

A spur is a calcium deposit that builds up over many months. It is not an extra bone that has been present since birth. It’s also often not even sharp or spiky – but tends to be more smooth at the edges. 

Heel spurs often develop in response to pressure or stress in the area, especially when ligaments are strained or tight. This, perhaps, is where some confusion arises – because when you have repetitive strain on a tissue called the plantar fascia, which attaches to the bottom of the heel, you also develop a heel spur as a result of the stress. The reality is that you’ll likely already be suffering from plantar fasciitis heel pain at this point, and the spur can also develop as a side-effect, instead of being the cause of the pain.

 

Who gets heel spurs

Anyone can develop a heel spur at any age if they have stress to their tissues or other causative factors. It’s the reason why Donald Trump received a draft deferment during the Vietnam War, according to the New York Times.

 

Heel spurs don’t equal pain

Just because you have a heel spur on an x-ray, doesn’t mean you’ll be feeling any heel pain. It is estimated that 10% of the population have a heel spur, and only half of these people will experience any heel pain, according to the American Academy of Orthopedic Surgeons. Here at Sole Motion, we see many radiographs of patients that don’t have heel pain but do have a heel spur, or that do have heel pain but do not have a heel spur.

Heel spurs won’t cause your heel pain unless the spur is in a position where it’s pressing on other bones or tissues, or rubbing against muscles or tendons, thereby damaging them and resulting in pain and swelling. The real reason for heel pain in most people is plantar fasciitis.

 

Plantar fasciitis heel pain

As the most common cause of ongoing heel pain in Australia, plantar fasciitis is what most people are really referring to when they come in with ‘heel spurs’. Your plantar fascia is a thick, flat band of connective tissue that starts at the bottom and inside of the heel, and fans out across the arch to connect to all five toes.

It plays a number of important roles in helping support your arch and the movement of your feet, thereby helping you walk efficiently. 

Picture this: every time you plant your foot on the ground, you’re putting tension on and stretching the plantar fascia. Now, it’s absolutely designed to take on a normal amount of tension and still be able to function perfectly. However, when your flat foot posture means that your foot continuously pancakes down to the floor, you decide to suddenly increase your run from 30 minutes to three hours without proper preparation, or you change from wearing shoes with good arch support to spending long days in flat fashion shoes, you can imagine the effect it’ll have on the fascia: micro-tears and damage. And just like that, you have an overuse injury known as plantar fasciitis.

 

I understand the difference. Now, what should I do if I have heel pain right now?

The first thing you should do is get the right diagnosis for your heel pain. This doesn’t just mean differentiating between a heel spur and plantar fasciitis, but also damage to a number of other muscles and tissue that start at the heel and run across the arch such as the abductor hallucis tendon. We highly recommend seeing someone that is a heel pain expert, as other less common causes of heel pain are often overlooked, or you may even receive the ol’ ‘heel spurs’ diagnosis – in which case you may already have a better understanding of heel pain vs. heel spurs from what you’ve read here! If you’re in Point Cook and the surrounds, we’re your local heel pain experts.

Next, it’s important to understand every part of your treatment provided by your practitioner. Don’t be afraid to ask questions, so you have a good understanding and are fully informed about how every part of your treatment is working to help you. When you understand why you’re doing what you’re doing, you’re also more likely to make the right day-to-day decisions when it comes to your foot health, and so have a better and easier recovery.

 

Here at Sole Motion, we create a completely tailored treatment plan for each person, that considers your unique foot characteristics, work-life balance, daily activities, preferences, and more. We may use:

• Strapping – we’ll almost certainly use some strapping initially to give you some much-needed support and pain relief for your fascia. Most people notice the difference within the first few steps
• Functional foot orthotics – these would be custom-made from the results of a comprehensive biomechanical assessment that we’d perform, the prescription we create, and an impression of your feet. They’ll work to keep your arch and heels supported with every step, so you can continue to walk while your fascia heals and without causing further strain and damage
• The right footwear – we’ll ensure the shoes you’re wearing throughout the day are supporting your recovery, and not working against you. Don’t worry – most people can still wear their work boots, dress shoes or joggers (provided they have orthotics in them) and any changes to footwear is very short-lived – only while you’re still getting pain
• Braces – if your pain is severe, you may have a partial tear in your fascia. In this case, we’ll send you for imaging, and get you in a brace to help maximally offload the tissue. This is very important to help you get the best results – and to stop the tear from getting bigger
• THOR laser – unique to our clinic, laser treatment is the secret weapon that helps us heal soft injuries faster than we’ve seen in our years of practice. Laser is completely safe, has no side effects, and is pain-free and heat-free. Read more about it here.

 

Need help from the heel pain experts?

If you have heel pain, we’re here to help. Book your appointment with our experienced team in Melbourne’s Point Cook online here or call us on 1300 FX FEET