A calcaneal spur (also known as a heel spur) is a bony outgrowth from the
calcaneal tuberosity (heel bone).
Calcaneal spurs are typically detected by
x-ray
An X-ray (also known in many languages as Röntgen radiation) is a form of high-energy electromagnetic radiation with a wavelength shorter than those of ultraviolet rays and longer than those of gamma rays. Roughly, X-rays have a wavelength ran ...
examination.
It is a form of
exostosis.
When a foot is exposed to constant
stress, calcium deposits build up on the bottom of the heel bone. Generally, this has no effect on a person's daily life. However, repeated damage can cause these deposits to pile up on each other, causing a
spur
A spur is a metal tool designed to be worn in pairs on the heels of riding boots for the purpose of directing a horse or other animal to move forward or laterally while riding. It is usually used to refine the riding aids (commands) and to ba ...
-shaped deformity, called a calcaneal (or heel) spur.
An inferior calcaneal spur is located on the inferior aspect of the
calcaneus
In humans and many other primates, the calcaneus (; from the Latin ''calcaneus'' or ''calcaneum'', meaning heel; : calcanei or calcanea) or heel bone is a bone of the Tarsus (skeleton), tarsus of the foot which constitutes the heel. In some other ...
and is typically a response to
plantar fasciitis
Plantar fasciitis or plantar heel pain is a disorder of the plantar fascia, which is the connective tissue that supports the Arches of the foot, arch of the foot. It results in pain in the heel and Sole (foot), bottom of the foot that is usuall ...
over a period, but may also be associated with
ankylosing spondylitis (typically in children). A posterior calcaneal spur develops on the back of the
heel at the insertion of the
Achilles tendon
The Achilles tendon or heel cord, also known as the calcaneal tendon, is a tendon at the back of the lower leg, and is the thickest in the human body. It serves to attach the plantaris, gastrocnemius (calf) and soleus muscles to the calcane ...
.
An inferior calcaneal spur consists of a
calcification
Calcification is the accumulation of calcium salts in a body tissue. It normally occurs in the formation of bone, but calcium can be deposited abnormally in soft tissue,Miller, J. D. Cardiovascular calcification: Orbicular origins. ''Nature M ...
of the calcaneus, which lies superior to the plantar fascia at the insertion of the plantar fascia. A posterior calcaneal spur is often large and palpable through the skin and may need to be removed as part of the treatment of insertional
Achilles tendonitis.
Signs and symptoms

Major symptoms consist of pain in the region surrounding the spur, which typically increases in intensity after prolonged periods of rest. Patients may report heel pain to be more severe when waking up in the morning. Patients may not be able to bear weight on the affected heel comfortably. Running, walking, or lifting heavy weight may exacerbate the issue.
Causes
Plantar fasciitis
Plantar fasciitis or plantar heel pain is a disorder of the plantar fascia, which is the connective tissue that supports the Arches of the foot, arch of the foot. It results in pain in the heel and Sole (foot), bottom of the foot that is usuall ...
is a common cause of calcaneal spurs. When stress is put on the plantar fascia ligament, it does not cause only plantar fasciitis, but causes a heel spur where the plantar fascia attaches to the heel bone.
The considerations that affect plantar heel pain are the alignment of the foot with lower leg, foot and ankle mobility, strength and endurance of muscle. External influences on plantar heel pain are the amount of time spent on feet while exercising or standing, type of footwear used and type of floor surfaces.
Calcaneal spur develops when proper care is not given to the foot and heels.
People who are
obese, have
flat feet, or who often wear
high-heeled shoes are most susceptible to heel spurs.
Flat feet can potentially be attributed to the minimal amount of
ankle dorsiflexion during stance phase of the
gait cycle causing more tension on the plantar fascia.
Diagnosis
X-rays are usually used to diagnose calcaneal spurs.
Treatment
It is often seen as a repetitive stress injury, and thus lifestyle modification is typically the basic course of management strategies. For example, a person should begin doing foot and calf workouts. Strong muscles in the calves and lower legs will help take the stress off the bone and prevent heel spurs. Icing the area is an effective way to get immediate pain relief. There are several means to get pain relief from plantar heel pain. Plantar heel pain can be a precursor to many pathologies of the foot.
There is evidence that corticosteroid injections may reduce pain for up to one month after the injection, which can have an impact on the formation of calcaneal spurs. Side effects of corticosteroid injections include peripheral nerve injury, plantar fascia rupture, and post injection flare, among others. Laser therapy, dry needling, and calcaneal taping are also utilized in treating plantar heel pain, however, there is no high quality evidence supporting the clinical usage of such modalities in reduction of pain.
Prognosis
According to studies following patients with plantar fasciitis and calcaneal spur over several years, 20% to 75% of individuals no longer have any symptoms within a maximum of one year after the onset of symptoms.
References
External links
{{Soft tissue disorders
Foot diseases
Soft tissue disorders