Calcaneal spurs - are they clinically relevant?

Historically, we have been taught to view a heel spur as a secondary complication to plantar fasciitis, and not a part of the pain syndrome. It seems these thought processes have changed.

Thanks to one of our members for posting this question. 'you mention heel spurs as being more important than we thought. Most of us still say they are not important - can you also fill me in here?'

According to Menz et al (2008) Calcaneal spurs are common in older men and women and are related to obesity, osteoarthritis and current or previous heel pain, but are unrelated to radiographic measurements of foot posture. These findings support the theory that plantar calcaneal spurs may be an adaptive response to vertical compression of the heel rather than longitudinal traction at the calcaneal enthesis.

So what IS a spur?

Anatomically, the plantar fascia originates from the medical tubercle of the calcaneus. Although some believe that the apex of the spur lies within the origin of the plantar fascia, its location is in fact superior to the plantar fascia in the origin of the flexor digitorum brevis muscle. Cadaveric specimen studies have also demonstrated that the attachment of abductor hallucis muscle is directly at the spur apex and may in fact contribute to spur formation.

Simon Bartold
Director of Bartold Clinical