Calcaneal Spurs

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Original Editors - Caro De Koninck

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Search Strategy[edit | edit source]

key-words:
calcaneal spur, heel spur, bone spur, plantar fasciitis 

Definition/Description[edit | edit source]

A calcaneal spur occurs when there is a bone spur, a small bony outgrowth, formed on the heel bone. A more common name for calcaneal spur is heel spur. Calcaneal spurs can be located at the back of the heel or under the sole. Spurs at the back are often associated with Achilles tendonitis, while spurs under the sole are associated with plantar fasciitis.

Clinically Relevant Anatomy[edit | edit source]

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Epidemiology /Etiology[edit | edit source]

The etiology of the spur have been debated. At the beginning of the twentieth century, gonorrhea was considered a prime ethiological factor. Heredity, metabolic disorders, tuberculosis, systemic inflammatory diseases and many other disorders have also been implicated. Now abnormal biomechanics (excessive pronation) enjoys wide support as the prime etiological factor for the painful plantar heel and the inferior calcaneal spur. The spur is thought to be a result of the biomechanical fault and an incidental finding when associated with the painful plantar heel. [1]

Characteristics/Clinical Presentation[edit | edit source]

The painful heel is a relatively common foot problem but calcaneal spurs are not considered a primary cause of heel pain. Most heel pain patients are middle-aged adults. Many of them are obese, so obesity can be considered a risk factor.

Not all heel spurs cause symptoms but when they to people often experience more pain during weight-bearing activities, in the morning or after a period of rest. The pain however is not the result of pressure of weight on the top of the spur but the experienced pain is coming from an inflammation around tendons where they attach to the bone.  

Differential Diagnosis[edit | edit source]

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Diagnostic Procedures[edit | edit source]

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Outcome Measures[edit | edit source]

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Examination[edit | edit source]

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Medical Management
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Physical Therapy Management
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Key Research[edit | edit source]

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Resources
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Clinical Bottom Line[edit | edit source]

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Recent Related Research (from Pubmed)[edit | edit source]

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References[edit | edit source]


1. Edmund M, Kosmahl PT, MS, Herbert E, Kosmahl DPM. Painful Plantar Heel, Plantar Fasciitis, and Calcaneal Spur: Etiology and treatment. J Orthop Sports Phys Ther 1987; 9(1)
2. D'andrea Greve JM, Grecco MV, Santos-Silva PR. Comparison of radial shockwaves and conventional physiotherapy for treating plantar fasciitis. Clinics 2009; 64(2) http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322009000200006&lng=en&nrm=iso&tlng=en (accessed 20 november 2010)
5. De Vera Barredo R, Menna D, Farris JW. An evaluation of research evidence for selected physical therapy interventions for plantar fasciitis. J Phy The Sci 2007; 19: 41-56 http://www.jstage.jst.go.jp/article/jpts/19/1/41/_pdf (accessed 20 november 2010)
3. Buchanan J, Buchbinder R, Forbes A, Gordon J, Prabaharan V, Ptatsnik R. Ultrasound-guided extracorporeal shockwave therapy for plantar fasciitis. JAMA 2002; 288: 1364-1372
http://jama.ama-assn.org/content/288/11/1364.full.pdf+html (accessed 27 december 2010)
4. Buch M, Haake M, Schoellner C, Goebel F, Vogel M, Mueller I, Hausdorf J, Zamzow K, Schade-Brittinger C, Mueller H-H. Extracorporeal shock wave therapy for plantar fasciitis: randomised controlled multicentre trial. BMJ 2003; 327 http://www.bmj.com/content/327/7406/75.full.pdf (accessed 27 december 2010)

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