The Plantar Fascia is a flat tendon that stretches from the bottom of the heel to the five digits.
Long standing, high heels, arch deficient shoes, and obesity cause gradual contraction of the tendon leading to partial tearing at the
 heel insertion. This tearing causes bleeding, inflammation and gradual calcification which on Xray appears as a spur. During an attack
 of pain, one needs to stay off the feet,  use heat and anti-inflammatory drugs. A steroid injection is sometimes necessary. The best long
 term result is yielded by arch preserving orthotics which cause a gradual stretching of the plantar  tendon.
Surgery to detach the plantar fascia from the heel is needed in refractory cases. Heel stretching splints
worn nightly are not as helpful as continually worn orthotic inserts.