Differential Diagnosis of Heel Spurs

While heel pain is most commonly caused by plantar fasciitis, which can lead to a bony growth, or heel spur, it is also attributed to tendonitis, bursitis, heel pad atrophy, arthritis, tarsal tunnel syndrome and calcaneal stress fractures.

Heel Spurs

• According to the American Podiatric Medical Association, heel spurs result from strain on the muscles and ligaments of the foot and by stretching of the long band of tissue that connects the heel and the ball of the foot, the plantar fascia. In a protective response, the body produces calcium deposits on the heel bone where it attaches to the plantar fascia. With a heel spur you will notice pain when you first put your feet on the floor or the pain will gradually worsen as you are on your feet.

Plantar Fasciitis

• Mayo Clinic.com defines this leading cause of heel pain as inflammation of a thick band of tissue, called the plantar fascia, which runs across the bottom of your foot--connecting your heel bone to your toes. You will have increased heel pain with your first steps in the morning or when you stand up after sitting awhile. The good news, MayoClinic.com reports, is that about 90 percent of plantar fasciitis sufferers recover with conservative treatments in just a few months.

Tendonitis

• If you have pain while running or jumping and tightness, the diagnosis could be Achilles tendonitis. This is inflammation of the Achilles tendon, which attaches the calf muscles to the heel bone.

Bursitis

• The bursa is a fluid-filled sac that should prevent tendons and bones from rubbing together. The bursa becomes inflamed and the soft tissue near the tendon becomes irritated when the heel bone, the Achilles tendon and the shoe rub together.

Less Common Causes

• Less common causes of heel pain that should be considered when symptoms last longer than six weeks include osteomyelitis, stress fracture, heel pad atrophy, arthritis and tarsal tunnel syndrome.