To determine whether it is an Achilles tendonitis or a bone spur, the main factors are the location of the lesion, the nature of the pain, the physical examination such as where the pressure point is located, and the auxiliary examination such as X-rays and magnetic resonance imaging. 1. Location of the lesion: Achilles tendonitis occurs at the attachment of the Achilles bone to the Achilles tendon, on the back side of the heel, while bone spurs usually occur below the Achilles bone. 2. The nature of the pain: Achilles tendonitis pain usually appears or aggravates after strenuous exercise, while the pain of bone spur is usually more obvious when you just get off the ground, and the pain will be alleviated or even disappeared after walking for a certain period of time. 3. Physical examination: the pressure point of Achilles tendonitis is at the attachment of Achilles bone and Achilles tendon at the back side of the heel, and the pressure point of bone spur is usually at the plantar part of the foot. 4. Auxiliary examination: X-ray film of Achilles tendonitis usually has no abnormality, and X-ray film of bone spur usually shows localized bone cumbersome formation. Through the above several specific aspects can determine the Achilles tendonitis and bone spurs, but the specific diagnosis and treatment also need to professional physician comprehensive judgment.