"Is it a heel spur?"

This is a question we often get asked by those suffering from heel pain, so in this blog, we will discuss the role that heel spurs play in plantar heel pain.

Heel spurs are actually quite common, with 15% of the population having one (Moroney et al 2014, Kilpatrick 2017). Interestingly heel spurs are more likely seen in those with a higher BMI, those suffering lower limb pain, or in those with osteoarthritis (anywhere in the body), suggesting a possible reactive process. And whilst they are found in 45–85% of those with plantar heel pain, does the heel spur itself actually cause pain?

Whilst having a heel spur suggests you are more likely to have pain, the spur itself does NOT necessarily cause pain. In fact, there are a large proportion of people that have heel spurs & are totally asymptomatic.

It was initially thought that heel spurs were the result of traction from the plantar fascia or intrinsic muscles of the foot, however, it is now thought that the spur is an adaptive skeletal response to redistribute the impact forces away from the calcaneal insertion site to the surrounding tissues.

So the key takeaway here, is that heel spur is unlikely to be the cause of your symptoms, but it may be an indication that the area is under increased load.

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References

• Kirkpatrick J, Yassaie O, Mirjalili SA. The plantar calcaneal spur: a review of anatomy, histology, etiology and key associations. J Anat. 2017 Jun;230(6):743-751

• Moroney, P. J., et al. (2014). "The conundrum of calcaneal spurs: do they matter?" Foot Ankle Spec 7(2): 95-101.