Frequently Asked Questions About Plantar Fasciitis vs Heel Spurs

Can you have both plantar fasciitis and a heel spur?

Yes, and this is actually very common. Chronic plantar fasciitis causes sustained pulling on the calcaneus (heel bone), which triggers your body to deposit calcium at the attachment point — forming a heel spur. In our clinic, about 50% of patients with longstanding plantar fasciitis also have a heel spur visible on X-ray. The spur itself rarely causes pain; the inflamed fascia is the source.

Do heel spurs need to be removed surgically?

Almost never. Since the spur itself is rarely the pain generator, removing it doesn’t fix the problem. Treatment targets the plantar fasciitis with stretching, orthotics, and sometimes shockwave therapy. In over 3,000 surgeries, I’ve removed a heel spur only when it was unusually large and directly compressing soft tissue — which is extremely rare.

How long does plantar fasciitis take to heal?

With proper treatment (stretching, supportive insoles, and activity modification), most patients see significant improvement within 6-8 weeks. About 90% of plantar fasciitis cases resolve with conservative treatment within 6 months. Cases lasting longer than 6 months may benefit from shockwave therapy or PRP injection.

What does a heel spur feel like vs plantar fasciitis?

They feel almost identical because the pain comes from the same area — the bottom of the heel. The classic pattern is sharp, stabbing heel pain with first steps in the morning that improves after walking for a few minutes. This pattern points to plantar fasciitis regardless of whether a spur is present. Point tenderness directly on the heel bone may suggest a spur-related bursitis, but this is uncommon.

Dr. Thomas Biernacki, DPM

— Board-Certified Podiatrist

Last Updated:

March 2026 |

Reading Time:

4 min

This article is for informational purposes only and does not replace professional medical advice. Schedule an appointment for personalized care.

Watch Dr. Tom explain plantar fasciitis and heel pain causes:

In This Guide

Plantar Fasciitis and Heel Spurs: Understanding the Difference

Many patients come to Balance Foot & Ankle confused about whether they have plantar fasciitis, a heel spur, or both. The distinction matters because it affects your treatment plan. Here is what our podiatrists want you to know.

What Is Plantar Fasciitis?

Plantar fasciitis is inflammation of the plantar fascia — the thick band of tissue that runs along the bottom of your foot from the heel bone to the toes. It is the most common cause of heel pain, affecting approximately 2 million Americans each year. The hallmark symptom is sharp, stabbing heel pain with the first steps in the morning that gradually improves with movement but may return after prolonged standing or sitting.

What Is a Heel Spur?

A heel spur (calcaneal spur) is a bony calcium deposit that forms on the underside of the heel bone. Heel spurs develop over months as the body responds to chronic strain on the plantar fascia. About 70% of patients with plantar fasciitis have heel spurs on X-ray. However, here is the critical point: the spur itself rarely causes pain. Many people have heel spurs with no symptoms at all.

So What Actually Hurts?

In the vast majority of cases, the pain comes from the inflamed plantar fascia, not the bone spur. This is why treatment focuses on reducing inflammation and supporting the fascia rather than removing the spur. Research consistently shows that treating the plantar fasciitis resolves the heel pain, even when a spur is present.

Treatment at Balance Foot & Ankle

Our podiatrists use a progressive treatment approach. First-line treatments include stretching protocols, custom orthotics, anti-inflammatory measures, and proper footwear. Advanced treatments for persistent cases include extracorporeal shockwave therapy (ESWT), corticosteroid injections, and platelet-rich plasma (PRP) therapy. Surgery is rarely needed — over 90% of plantar fasciitis cases resolve with conservative treatment.

Read our complete plantar fasciitis treatment guide →

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• Custom Orthotics vs Insoles
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Dr. Tom’s Recommended Products: See our clinically tested product recommendations for this condition. View Dr. Tom’s recommended products →

When to See a Podiatrist for Heel Pain

If you’re experiencing heel pain that persists for more than two weeks, especially if it’s worse with your first morning steps, a board-certified podiatrist can diagnose the underlying cause and create a personalized treatment plan. At Balance Foot & Ankle, we offer comprehensive heel pain diagnosis using digital X-ray and biomechanical assessment at our Howell and Bloomfield Hills offices.

→ Learn about our Plantar Fasciitis Treatment options
→ Book your appointment
→ Call (810) 206-1402

Clinical References

1. Riddle DL, Schappert SM. Volume of ambulatory care visits and patterns of care for patients diagnosed with plantar fasciitis. J Athl Train. 2004;39(1):51-56.
2. Menz HB, Zammit GV, Landorf KB, Munteanu SE. Plantar calcaneal spurs in older people: longitudinal traction or vertical compression? J Foot Ankle Res. 2008;1(1):7. doi:10.1186/1757-1146-1-7
3. Martin RL, Davenport TE, Reischl SF, et al. Heel pain — plantar fasciitis: revision 2014. J Orthop Sports Phys Ther. 2014;44(11):A1-33. doi:10.2519/jospt.2014.0303

Dr. Tom Biernacki, DPM

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Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has reached over one million views.