Sharp heel pain that hits hardest with your first steps in the morning is one of the most common complaints our Brisbane podiatrists assess. Plantar fasciitis and heel spurs are frequently confused for one another, but they are distinct conditions that require different management approaches.
At Expert Foot Care, our senior podiatrists bring over 15 years of clinical experience to the assessment and treatment of heel pain across Brisbane. This guide explains what each condition involves, how they differ, and what effective treatment looks like.
What is Plantar Fasciitis?
The plantar fascia is a thick band of connective tissue running along the sole, connecting the heel bone to the base of the toes. Plantar fasciitis develops when this tissue becomes inflamed, typically at the point where it attaches to the heel bone.
Plantar fasciitis treatment in Ashgrove and across Brisbane is one of the most common reasons patients visit our clinic. It is estimated to affect around one in ten people at some point in their lives.
Common Causes
- Overuse from running, prolonged standing, or high-impact sport
- Biomechanical factors, including flat feet, high arches, and overpronation
- Rapid increases in training volume or activity
- Inadequate footwear with poor arch support or cushioning
- Age-related loss of tissue elasticity
Symptoms
- Sharp heel pain worst with the first steps in the morning or after prolonged rest
- Pain that eases with movement but returns after extended activity
- Tenderness on the underside of the heel when pressure is applied
What is a Heel Spur?
A heel spur is a bony outgrowth that forms on the underside of the heel bone in response to chronic mechanical stress. It typically develops over months or years and is often discovered incidentally on X-ray.
Importantly, heel spurs are not always painful. Many people have a spur on imaging with no symptoms at all. Pain in the heel is driven by tissue inflammation and mechanical loading, not the spur itself in most cases.
Common Causes
- Chronic plantar fasciitis places repeated stress on the heel bone attachment
- Prolonged standing, running, or high-impact activity
- Flat foot mechanics that increase load at the plantar fascia insertion
Symptoms
- A localised ache or heat sensation at the base of the heel during or after activity
- Pain that intensifies after rest, then eases with movement
- Tenderness at a specific point on the underside of the heel
How Are They Related?
Chronic plantar fasciitis places sustained stress on the heel bone at the plantar fascia insertion. Over time, the body responds by laying down new bone, forming a heel spur. However, over 90% of patients with plantar fasciitis do not have a heel spur, and a spur on imaging does not determine whether pain will be present.
This distinction matters for treatment. Managing heel pain effectively means addressing the soft tissue inflammation and biomechanical drivers, not the spur itself. Surgery to remove a heel spur is rarely indicated and rarely resolves symptoms when the plantar fascia is the actual pain source.
How We Diagnose Heel Pain
Our podiatrists do not rely on imaging alone. Every assessment at Expert Foot Care begins with a thorough clinical examination.
A heel pain assessment at our Brisbane clinic includes:
- Physical examination – palpating the plantar fascia, assessing joint range of motion, and evaluating arch structure
- Biomechanical assessment – identifying structural and mechanical factors contributing to excess plantar fascia load
- Gait analysis – evaluating walking and running mechanics where relevant
- Footwear review – examining wear patterns, fit, and support adequacy
- Imaging referral where indicated – X-ray for bony changes, ultrasound to assess plantar fascia thickness and integrity
Findings are explained clearly at the end of every appointment in plain language.
Plantar Fasciitis Treatment: What We Recommend
Treatment at Expert Foot Care is determined by individual assessment findings, not a generic protocol. Most cases respond well to conservative management. For persistent presentations, we offer highly effective clinical treatments.
- Custom Orthotics
Custom orthotics prescribed by our Brisbane podiatrists are designed to correct the specific biomechanical factors driving each patient’s plantar fasciitis. Prescribed from a 3D foot scan, they reduce load on the plantar fascia and redistribute pressure across the foot during activity.
- Shockwave Therapy
Shockwave therapy is one of the most effective treatments for persistent plantar fasciitis. It uses targeted acoustic wave energy to stimulate tissue healing and reduce chronic inflammation. At our Alderley clinic, most patients notice meaningful improvement within three to five sessions. Evidence for shockwave therapy in chronic plantar fasciitis is well established in clinical podiatry guidelines.
- Laser Therapy
Laser therapy at Expert Foot Care is used for pain reduction, increased tissue repair, and healing. For patients managing persistent inflammation and soft tissue irritation, it provides an effective non-invasive complement to other treatments.
- Stretching and Rehabilitation
A structured programme targeting the calf muscles, plantar fascia, and intrinsic foot muscles reduces load on the fascia and addresses the muscular contributors to the condition. Your podiatrist will prescribe and review this programme throughout your recovery.
Heel Spur Treatment
Because heel spurs are rarely the primary pain source, treatment focuses on the underlying inflammation and mechanical loading. The approach closely mirrors plantar fasciitis management.
For patients with confirmed spurs and significant pain, corticosteroid injection may be considered where conservative measures have not provided adequate relief. This is always discussed openly before proceeding. Surgical intervention is rare and only considered after an extended course of conservative management has been exhausted.
Heel Pain in Runners and Older Adults
Running heel pain is a common presentation at our sports podiatry clinic. Runners place a significant repetitive load through the plantar fascia with every stride, and biomechanical inefficiencies that cause no symptoms at low volumes can produce significant pain as training load increases. Our podiatrists develop return-to-running plans that allow progressive loading alongside treatment, minimising time away from sport.
Our team are experts in treating the 55+ demographic, and plantar fasciitis is significantly more prevalent in older adults. The natural thinning of the heel fat pad with age reduces shock absorption and increases plantar fascia load. Slower tissue healing also means chronic presentations are more common and require more careful, individualised management.
For patients across Ashgrove, Alderley, and Enoggera, our clinic provides accessible, experienced heel pain assessment and treatment with continuity of care from the same senior podiatrist.
Recovery: What to Expect
Acute plantar fasciitis presenting within the first few weeks typically responds well within six to eight weeks of targeted treatment. Chronic cases that have been present for six months or longer take more time and benefit significantly from shockwave therapy.
Consistency with the prescribed programme makes a meaningful difference to recovery speed. Our podiatrists set clear expectations at the outset, provide realistic timelines, and adjust the plan based on your progress at each review.
Book a Heel Pain Assessment in Brisbane
Heel pain that disrupts your mornings or keeps returning after short periods of improvement deserves professional assessment. The longer plantar fasciitis goes unaddressed, the more likely it is to become a chronic condition requiring more extensive treatment.
At Expert Foot Care, our senior podiatrists assess thoroughly, explain clearly, and develop plans tailored to your individual circumstances. We prioritise conservative management and do not recommend treatments before fully understanding your situation.
New patients are welcome to ask about our complimentary comprehensive foot health assessment when booking.
📞 Call us on(07) 3256 8638
🌐 Book online at expertfootcare.com.au
📍 Serving Ashgrove, Alderley, Enoggera, Everton Park, Stafford, Wilston and surrounding Brisbane suburbs.
Quick Answers
Is plantar fasciitis the same as a heel spur?
No. Plantar fasciitis affects the plantar fascia beneath the foot, while a heel spur is a bony growth on the heel. They can occur together but are different conditions.
Which causes heel pain: plantar fasciitis or a heel spur?
Plantar fasciitis is commonly responsible for heel pain, while many heel spurs cause no symptoms. Pain is often related to irritated or overloaded soft tissue rather than the spur itself.
Can you have plantar fasciitis without a heel spur?
Yes. Plantar fasciitis does not require a heel spur to develop. Imaging may show no spur even when a person has typical plantar fasciitis symptoms.
Can a heel spur go away without surgery?
Heel spurs generally do not need to be removed. Treatment usually focuses on addressing the factors contributing to heel pain rather than removing an incidental bony growth.
When should I see a podiatrist for heel pain?
Persistent heel pain, pain affecting walking or exercise, or symptoms that are not improving with appropriate self-care should be professionally assessed to determine the underlying cause.
FAQs
What is the difference between plantar fasciitis and a heel spur?
Plantar fasciitis involves irritation and pain affecting the plantar fascia beneath the foot. A heel spur is a bony growth that develops on the heel bone. They are related but not the same condition.
Is a heel spur the cause of plantar fasciitis?
Not necessarily. A heel spur can develop alongside long-standing plantar fascia problems, but the spur itself is not usually considered the primary cause of plantar fasciitis pain.
What does plantar fasciitis pain feel like?
Plantar fasciitis commonly causes sharp or aching pain underneath the heel, particularly during the first steps after getting out of bed or after sitting for an extended period.
What are the symptoms of a heel spur?
A heel spur may cause no symptoms at all. When heel pain is present, it may feel similar to plantar fasciitis because the surrounding tissues can also be irritated or overloaded.
Why does my heel hurt when I first get out of bed?
Heel pain that is particularly noticeable during your first steps in the morning is a common pattern associated with plantar fasciitis.
Can you have both plantar fasciitis and a heel spur?
Yes. Plantar fasciitis and heel spurs can occur together. However, finding a heel spur on an X-ray does not necessarily mean the spur is responsible for the person’s pain.
Do heel spurs always hurt?
No. Many people have heel spurs without experiencing heel pain. This is why treatment should focus on identifying the actual source of symptoms rather than automatically blaming an X-ray finding.
Can plantar fasciitis occur without a heel spur?
Yes. A person can experience plantar fasciitis without having a visible heel spur. The two conditions should not be considered interchangeable.
Do I need an X-ray for plantar fasciitis?
Not usually. Plantar fasciitis can often be diagnosed through a clinical assessment of symptoms and the foot. Imaging may sometimes be considered to investigate other possible causes of heel pain.
Can a podiatrist diagnose plantar fasciitis?
Yes. Podiatrists can assess heel pain, examine foot and lower-limb function and help determine whether plantar fasciitis or another condition may be contributing to symptoms.
What causes plantar fasciitis?
Plantar fasciitis can be associated with increased physical activity, running, prolonged standing, unsupportive footwear, changes in exercise, flat feet, high arches and tight or weak calf muscles.
What causes heel spurs?
Heel spurs are associated with repeated mechanical stress around the heel. They can develop over time alongside conditions such as plantar fascia overload, although the presence of a spur does not necessarily explain heel pain.
Can running cause plantar fasciitis?
Yes. Running and other high-impact activities can place repeated stress on the plantar fascia, particularly when training loads increase rapidly or the foot is not adequately supported.
Can poor footwear cause heel pain?
Unsupportive footwear can contribute to heel pain by increasing stress on the structures supporting the foot. Appropriate footwear can be an important part of managing plantar heel pain.
How is plantar fasciitis treated?
Treatment may include activity modification, supportive footwear, stretching and strengthening exercises, orthotics or arch supports, taping and, in appropriate cases, shockwave therapy. Treatment should be tailored to the individual’s presentation.
How are heel spurs treated?
Treatment generally focuses on the underlying causes of heel pain and reducing excessive stress on the foot rather than simply removing the spur. Stretching, footwear changes and other conservative treatments may be appropriate.
Do heel spurs need surgery?
Usually not. Most heel spurs do not require surgical removal, particularly when the spur is not itself responsible for the person’s symptoms. Conservative treatment is generally considered first.
How long does plantar fasciitis take to improve?
Plantar fasciitis can take weeks or months to settle. Recovery varies depending on the severity of the condition, contributing factors, treatment and how consistently the underlying causes are addressed.
When should I see a podiatrist about heel pain?
Consider professional assessment if heel pain is persistent, worsening, affecting your ability to walk or exercise, or failing to improve with appropriate self-care. Heel pain can have several different causes, so an accurate assessment matters.
Can a Brisbane podiatrist treat plantar fasciitis?
A Brisbane podiatrist can assess the likely cause of heel pain and develop an individualised management plan. At Expert Foot Care in Alderley, assessment can include consideration of footwear, biomechanics, activity levels and treatment options.
Where can I get plantar fasciitis treatment in Brisbane?
Expert Foot Care provides podiatry assessment and treatment for plantar fasciitis and other causes of heel pain from its Alderley clinic, serving Brisbane’s Northside.
Is there a podiatrist for heel spurs in Brisbane?
Yes. A podiatrist can assess heel pain associated with a heel spur and determine whether the spur is clinically relevant or whether another condition, such as plantar fasciitis, may be responsible for symptoms.
What is the best treatment for a heel spur?
There is no single treatment that is best for everyone. The appropriate approach depends on why the heel is painful and may involve footwear changes, exercises, load modification, orthotic support or other podiatry treatments.
Can orthotics help plantar fasciitis?
Orthotics or arch supports may help some people by supporting the foot and modifying mechanical loading. Whether they are appropriate depends on the individual’s foot structure, symptoms and activity requirements.
Can shockwave therapy help plantar fasciitis?
Shockwave therapy is one treatment option that may be considered for plantar fasciitis, particularly when symptoms have persisted. It should form part of an appropriate treatment plan rather than being viewed as a universal solution.
Is all heel pain plantar fasciitis?
No. Heel pain can have several causes, including plantar fasciitis, Achilles tendon problems, bursitis, nerve-related conditions, injury and other disorders. A clinical assessment can help identify the likely source.
