County Physio | Haddington & East Lothian
Heel pain is extremely common — but many people are unsure whether they have plantar fasciitis or a heel spur.
Although these terms are often used together, they are not the same condition.
At County Physio in Haddington, we treat both regularly, and understanding the difference is essential to choosing the right treatment.
Here’s how to tell them apart — and what you can do to relieve your heel pain fast.
What Is Plantar Fasciitis?
Plantar fasciitis is inflammation and irritation of the plantar fascia, a thick band of tissue that runs from your heel to your toes.
Common symptoms include:
- Sharp heel pain when taking your first steps in the morning
- Pain after sitting or resting
- Pain after long periods of standing or walking
- Tenderness on the bottom of the heel
- Tightness in the calf or Achilles
Plantar fasciitis is the most common cause of heel pain.
What Is a Heel Spur?
A heel spur is a small bony growth on the heel bone (calcaneus).
It forms over time due to repeated strain on the heel.
Important:
Many people with heel spurs have NO pain at all.
Heel spurs are often discovered on an X-ray taken for other reasons.
When a spur does cause pain, it is usually because the tissues around it (like the plantar fascia) are irritated.
⭐ Plantar Fasciitis vs Heel Spur — The Key Differences
| Feature | Plantar Fasciitis | Heel Spur |
|---|---|---|
| What it is | Tissue inflammation | Bony growth |
| Pain location | Bottom of heel, arch | Bottom of heel |
| Morning pain | Very common | Less common |
| Visible on X-ray? | No | Yes |
| Does it always hurt? | Usually yes | Often no |
| Cause | Overload/tight fascia | Long-term stress on heel bone |
🤔 Which One Causes More Pain?
Most heel pain comes from plantar fasciitis, not heel spurs.
Studies show that many people with heel spurs feel no pain at all, while plantar fasciitis almost always causes discomfort, especially in the morning.
⭐ Can You Have Both?
Yes — and many people do.
In fact, when someone has both a spur and heel pain, the pain usually comes from plantar fasciitis, not the spur itself.
What Causes a Heel Spur to Form?
Heel spurs develop slowly due to long-term stress on the heel bone.
Common causes include:
- Tight calf muscles
- Flat feet or high arches
- Repetitive overload (running, walking, standing)
- Poor footwear
- Long-term plantar fasciitis
- Age-related changes
A heel spur is usually a symptom of chronic stress, not the root cause.
Do Heel Spurs Need Surgery?
In most cases, no.
Surgery is rare and only considered when:
- Pain is severe and persistent
- Physiotherapy and conservative treatments haven’t helped
- The spur is causing structural irritation
Most heel spur symptoms improve with physiotherapy.
⭐ How Physiotherapy Helps BOTH Conditions
Whether your heel pain comes from plantar fasciitis, a heel spur, or both — the treatment is very similar.
At County Physio, we focus on:
✔ Soft tissue release to the plantar fascia & calf
✔ Stretching to reduce morning pain
✔ Strengthening foot muscles
✔ Improving ankle and gait mechanics
✔ Reducing inflammation
✔ Taping or laser therapy
✔ Footwear and insole advice
Most people experience noticeable improvement within 2–4 weeks.
How Do You Know Which One You Have?
A physiotherapy assessment can usually determine the cause without X-rays.
Typical indicators:
Plantar Fasciitis:
- Pain with first steps in the morning
- Pain in heel AND arch
- Tight calves
- Starts after increased activity
Heel Spur:
- Deep, pinpoint heel pain
- Pain after walking long distances
- Known long-term stress on the heel
- Visible on X-ray (if taken)
If you’re unsure, let us assess it — we’ll guide you clearly.
Book a Heel Pain Assessment Today
Whether your pain is from plantar fasciitis, a heel spur, or both — effective treatment is available.
