Calcaneal spur

IIPO
 Objectives
• What is Calcaneal spur?
• Etiology
• Prescription criteria
• management
 Definition
• 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

examination.

•When a foot is exposed to constant stress, calcium

deposits build up on the bottom of the heel bone.
 Heel spurs are common and do not always cause pain,
with the surrounding soft tissue.

 It can be located at the back of the heel (dorsal heel spur) or

under the sole (plantar heel spur).

 The dorsal spurs are often associated with Achilles

Tendinopathy, while spurs under the sole are associated with
Plantar fasciitis.
 Causes
• The cause of heel spurs is not completely understood.

• They may be caused by pressure on the heel.

• In general, the cause of the pain is not the heel spur itself but
the soft-tissue injury associated with it.
• Heel spurs occur when calcium deposits build up on
the underside of the heel bone, a process that usually
occurs over a period of many months.
• Often caused by strains on foot muscles and
ligaments, stretching of the plantar fascia, and
repeated tearing of the membrane that covers the heel
bone.
• These are especially common among athletes whose
activities include large amounts of running and
jumping.
 Signs and symptoms
 Pain in the bottom of your heel.

 Pain that is worse when you first get out of bed.

 Pain that gets worse after walking or standing.

 Patients may not be able to bear weight on the affected

heel comfortably.

 People who are obese, have flat feet, or who often

wear high-heeled shoes are most susceptible to heel spurs.
 RISK FACTORS
 older than 40.

 overweight.

 Have wear and tear arthritis (osteoarthritis).

 Have plantar fascia inflammation.

 Walking gait abnormalities, which place excessive stress

on the heel bone, ligaments, and nerves near the heel.

 Running or jogging, especially on hard surfaces.

 DIAGNOSIS
 Sharp pain localized to the heel.

 X-rays.
 Treatment
Rest: Getting plenty of rest and taking pressure off the
feet can help to reduce pain and swelling in the
affected area.

• Surgery
• Physical therapy
•Orthotics
 Physiotherapy
 Ultrasound

 Ice massage

 Thermotherapy.

 Low level laser therapy

 Extracorporeal Shock Wave Therapy

 Iontophoresis
 plantar fascia stretching

 Calf muscle stretch

 Orthotics
 Night Splints

 Shoe inserts

 Foot wear Modification

 Wearing cushioned sports shoes:

These may also help to relieve
pressure and reduce pain.
 Review Questions
• Heel spur is a bony outgrowth from the talus.(T/F)
• Heel spur can be located at the back of the heel. (T/F)
• The dorsal spurs are often associated with plantar fasciitis.
(T/F)
• Heel spur is common among athletes whose
activities include large amounts of running and
jumping. (T/F)
• Shoe insert is indicated for heel spur management. (T/F)
 References
1. https://www.clinicalkey.com/#!/content/patient_handout/5-s2.0-pe_ExitCare_DI_Heel_Spur_en
2. http://www.webmd.com/pain-management/heel-spurs-pain-causes-symptoms-treatments#1
3. http://www.physio-pedia.com/Calcaneal_Spurs
4. https://www.epainassist.com/sports-injuries/foot-and-heel-injuries/heel-or-calcaneal-spur
5. http://ard.bmj.com/content/71/Suppl_3/757.13
6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1753417/pdf/v060p01064.pdf
7. https://www.clinicalkey.com/#!/content/journal/1-s2.0-S1067251614005742
8. http://www.sportsinjuryclinic.net/sport-injuries/foot-heel-pain/heel-spur
9. http://www.shockwavetherapy.education/index.php/tutorials/ankle/heel-spurs
10. https://www.clinicalkey.com/#!/content/medline/2-s2.0-24172641
11. www.revrokineto.com/viewart/111/en
12. https://www.clinicalkey.com/#!/content/medline/2-s2.0-28214811