Heel spurs are often cited by various clinicians as being the causal factor when treating patients with plantar fasciitis type symptoms.
The question that many of us in the pain world often ask is whether or not the spur is actually associated with the individual’s symptoms or if it is just a factor that is blamed too often.
In our first study (see references below), it was reported that significantly more heel spurs were observed in those with plantar fasciitis versus a comparison group.
However, other studies (2nd reference) report that heel spurs occur in a good chunk of the asymptomatic population (19% in this study) and that we should be careful to blame an individual’s pain on this finding.
Whether heel spurs are or aren’t associated with pain may not matter a whole lot as it doesn’t really change our rehab treatment plan much. In most cases, these individuals present with plantar fasciitis type symptoms, so we implement interventions that have been shown to help this condition (3rd reference).
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References:
1. Johal KS, et al. Plantar fasciitis and the calcaneal spur: Fact or fiction? Foot Ankle Surg. 2012.
2. Ehrmann C, et al. Calcaneal attachment of the plantar fascia: MR findings in asymptomatic volunteers. Radiology. 2014.
3. Rathleff MS, et al. High-load strength training improves outcome in patients with plantar fasciitis: A randomized controlled trial with 12-month follow-up. Scand J Med Sci Sports. 2015.
