What Is the Difference Between a Heel Spur & Neuropathy?

Tingling, burning, stabbing, shooting: All of these words describe a tender or painful heel. A proper diagnosis of heel pain is important in finding the treatment that will provide the greatest relief. Two common but very different conditions that cause pain in the heel are heel spurs and neuropathy.

Neuropathy

• Neuropathy, or nerve damage, affects more than 20 million Americans, according to the Neuropathy Association. Neuropathy is not a specific disease but a combination of conditions that damages the nerves carrying signals between the brain and the muscles, skin and internal organs. According to Podiatry Today, entrapment neuropathy of the the tarsal tunnel, located in the heel, is a painful condition that can be challenging to diagnose. This is because it often occurs in conjunction with other conditions, such as a heel spur or plantar fasciitis, inflammation of heel tissue.

Neuropathy Causes and Symtoms

• Unfortunately, 30 percent of neuropathy cases are of unknown origin. Another 30 percent are a result of diabetes. The American Diabetes Association reports that about half of the people with diabetes have some form of nerve damage known as diabetic neuropathy. Neuropathy can come and go, slowly progressing over many years, or it can become severe and debilitating.

Heel Spur

• A heel spur is an abnormal bony growth on the heel bone. The spur itself is not the source of pain, but pain is experienced when the spur rubs nearby nerves, soft tissue and bone. According to the University of Iowa Hospitals and Clinics, the pain comes from the plantar fascia, a thick, fibrous tissue that supports the arch on the sole of the foot. The longer the plantar fasciitis lasts, the greater the chance that a heel spur will form.

Heel Spur Causes and Symptoms

• A heel spur is usually caused by abnormal pronation, the foot moving incorrectly. The spur grows slowly over time. 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 during the day.

Treatments

• Conservative treatment for both nerve entrapment and heel spur includes orthotics--supportive devices, such as shoe inserts--to correct biomechanical issues and to keep the foot in the proper position. Anti-inflammatory drugs are used to reduce swelling and minimize pain. A physician can prescribe physical therapy or inject the heel with corticosteroids and local anesthetics. If your symptoms last more than six weeks, surgical intervention may be necessary.