The causes of calcaneal spurs

, medical expert
Last reviewed: 05.10.2018

All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.

We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.

If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.

The lower extremities and in particular the feet are parts of the human body that are under maximum load. The most important thing is that of the foot, which is usually called the heel, because he has to withstand the weight of the entire human body. And it is not surprising that under the influence of some provoking factors and age-related changes in various tissues of the heel, pathological changes can occur, such as the formation of a painful growth, called a calcaneal spur. The causes of calcaneal spurs may be different and most often it affects the representatives of the weaker sex who have crossed the 40-year mark. But you need to make a reservation that in fact, virtually no one is insured from this pathology, it is only necessary to carefully study the factors that cause degenerative changes in the tissues of the foot and heel.

What is the heel spur?

A sharp pain in the foot, which does not allow a person to lean on the heel when walking or standing in place, in the absence of a serious injury with heel bone damage is considered a clear symptom of plantar fasciitis. The very name of the disease says that we are dealing not just with a pain syndrome, the occurrence of which is associated with mechanical or thermal damage to the skin, muscles or bones, but with inflammation of the tissues in the heel, or rather at the junction of the calcaneus and Achilles tendon.

Thus, plantar (or plantar) fasciitis is an inflammation of soft tissues - fascia (a connective tissue covering the human organs and integrating them among themselves) in the foot area. But what does the heel spur have here, which, judging by the name, has a slightly different character than simple inflammations of muscles or fasciae?

The fact is that in people the heel spur is often called plantar fasciitis because of the similarity of symptoms of pathology. A sharp pain with pressure on the heel is the main symptom of both pathologies, but it is also the cause of confusion. In reality, plantar fasciitis can be considered the most common cause of calcaneal spurs, as the disease causes inflammatory-degenerative changes in various foot tissues.

By nature, heel spurs are one of the varieties of osteophytes - bone growths that can form on the surface of the bones of the upper and lower extremities (most often at the terminal parts of the bones in the joint region, but sometimes they can be expected along the bone). Such a build-up on the calcaneus usually has the form of a spine with a rather sharp end (resembles an ankle on the cock's leg, called a spur). When a person steps on the heel, the build-up begins to push hard on the soft tissues of the sole, resulting in a painful sharp pain that patients usually turn to the doctor.

Since the  calcaneal spur  is an outgrowth inside the tissues, and it is not visible to the naked eye, many have the question, how does the calcaneal spur, which causes so much pain and suffering, really look? The calcaneal spur has a slightly unusual shape with a point pointing to the anterior part of the foot and slightly curved upward. Its size can vary, because now the inflammation in the heel supports the build-up itself, regularly injuring soft tissues. And chronic inflammation, in the end, provokes metabolic disorders and dysplastic processes in bone tissues that cause not only the appearance, but also the subsequent growth of the osteophyte.

In the calcaneus, the inflammatory process usually occurs in the region of attachment of the plantar fascia (fasciitis) to it. The pustule, unlike the bone itself, is provided with a variety of nerve endings that, when inflamed, cause pain. The inflammatory process in the periosteum leads to its thinning, but this part of the bone can not recover on its own, and the body begins to redirect to the calcium damage zone to hide the defect. Over time, if the inflammation is not suppressed, calcium accumulates and not only covers the defects of the periosteum, but also begins to protrude beyond its limits.

An identical situation can also be observed with hormonal failures and endocrine pathologies, when the metabolism in the body is disturbed. Disturbance of metabolism in various tissues of the heel (fascia, cartilaginous tissue, periosteum) is the reason that calcium salts begin to accumulate in the calcaneal region, which in time become denser and acquire the form characteristic of the heel spur. The longer the inflammatory process proceeds, the more the osteophyte will grow.

So it turns out that the calcaneal spur is the deposition of salts? In a sense, yes, when it comes to the accumulation of calcium salts. But do not confuse this pathology and the verdict "deposition of salts" in the case of arthritis, arthrosis, osteochondrosis, etc. The deposition of salts in large joints, as it is understood in medicine, is an accumulation in the region of the joints of uric acid salts (sodium and potassium salts), which cause destruction of bones and cartilage and provoke inflammatory processes. Here usually it is not only about the metabolic disturbances in the body, but also about the pathologies of the kidneys that cause a delay in uric acid in the body.

While the calcaneal spur is small (1-3 mm), the person does not experience discomfort in the heel area, and may not suspect a defect until it is accidentally detected by the x-ray of the foot, often done in connection with another disease. An increase in size from 4 to 12 mm can not help traumatizing the tissues around it, inflammation and pain, limiting the patient's movements and changing his gait, although there will be no visible changes in the foot.

Risk factors for calcaneal spurs

As we have already understood, heel spurs do not arise simultaneously and from scratch. Its appearance is preceded by long-lasting inflammatory processes, which the patient may not even suspect. This is the pathology of pathology, the diagnosis of which without an X-ray examination is very difficult, and prevention does not always give positive results.

Inflammation of the plantar fascia with the subsequent formation of a calcaneal spur can provoke the following situations:

  • Increased stress on the legs and heel bone due to excess weight, spine diseases, large joints of the lower extremities, congenital or acquired foot structure defects (for example, flat feet), changing the gait of a person,
  • Injuries to tendons, bones and soft tissues in the heel, which are almost always accompanied by an inflammatory process. Even a jump to a hard surface from a great height and the resulting severe injury to the tissues of the heel may subsequently lead to the appearance of a calcaneal spur.
  • Vascular and neurologic disorders in the lower limbs can also become one of the factors that cause inflammation and metabolic disorders in the foot tissues.
  • Inflammation of the periosteum of the calcaneus can be one of the symptoms of a chronic inflammatory process that has a generalized character. This is possible with gout, psoriatic arthritis, spondylitis, rheumatism, etc.).
  • Inflammation of mucous bags of joints in the calcaneus and Achilles tendon (subclavian and achillobursitis).
  • Large loads on the plantar fascia caused by professional activity (often plantar fasciitis suffer athletes whose ligaments are regularly covered with microcracks and become inflamed).
  • Inflammation of the tissues in the sole region can be caused by inappropriate or too narrow shoes, regular walking on high heels or barefoot on the surface with pronounced irregularities.
  • Hormonal disorders and endocrine diseases. In themselves, they rarely lead to such consequences, but any trauma on their background may be accompanied by an increased accumulation of calcium salts in the affected area.

Needless to say, with age, the likelihood of forming a calcaneal spur increases, and it's not just the physiological changes that lead to a disruption of the hormonal balance and a reduction in the fat layer in the sole area that softens the foot and hard surface interaction, but also in the luggage of the diseases that have accumulated a person for many years.

It turns out that the causes of heel spurs, these are the same factors that lead to the development of plantar fasciitis. True, not always inflammation causes the formation of bone growths on the heel. In the appearance of such spiny growths, it is necessary to blame the long-running inflammatory process and the regular traumatization of the foot tissues, which supports it.

In connection with the above, we can conclude that most often from the heel spurs suffer:

  • people with a large body weight (their legs are subjected to a heavy load daily),
  • Patients with flat feet (in this case, ligaments regularly suffer from incorrect redistribution of pressure),
  • athletes (frequent cases of sprain, the appearance of microcracks in the plantar fascia, large loads on the foot cause the heel spurs to appear much before 40 years),
  • Ladies who prefer high heels shoes on a comfortable sole.

These categories of people regularly load their legs, which leads to the development of various pathological processes in them, and the heel spur (no matter how painful its manifestations) is not the most terrible and them.

Symptoms of the calcaneal spur

Since heel spurs and plantar fasciitis are interrelated diseases, they are often confused because of the similarity of symptoms. At the same plantar fasciitis for the time being may be asymptomatic (as in the case of microfractures of the fascia, which a person can not sense). Even the appearance of the calcaneal spur is not always accompanied by discomfort when walking. It can appear already due to the pressure of the build-up on the tissues of the sole and their inflammation, i.e. When the build-up itself becomes the cause of the inflammatory process.

While the calcaneal spur does not bother the person, he is unlikely to be concerned about her education. But when symptoms of the disease appear, it will not be easy to tolerate them.

First, the built-up edge worries a person only during walking and the need to rely on the heel, but later it can cause not only a change in gait, the development of flat feet and spine diseases. Usually, pain is stronger in the morning, when a person gets out of bed (injured tissues have just begun to heal during rest, so they become very sensitive) and in the evening (due to the load on damaged tissue inflammation is aggravated).

As the growth of osteophytes and in the case of formation of outgrowths on two legs at once, the pain begins to torment the person even in a state of rest, when there is no load on the heel, and walking causes distressed pain, so that patients have to resort to a support (cane, crutches) on the foot.

Because of pain in the legs, a person tries to move less, and physical inactivity itself is dangerous for violations in the work of various organs. Its consequences are excess weight, disruptions in the digestive system, metabolic disorders, muscle atrophy, worsening of the brain and CNS. It turns out a vicious circle. Restricting motor activity, a person only provokes the growth of the heel spur, regardless of the cause of its occurrence.

It must be said that the strength of pain that patients characterize as acute, burning, as in the case when you step on a sharp object (nail, needle, etc.), depends not so much on the size of the bone growth as on its location. The severity of pain is higher, the more nerve endings are squeezed by the spur. In this case, pain from the compressed nerve joins pain from inflammation of the periosteum. And often it starts to hurt not only the heel, but the entire foot, and sometimes even the ankle.

External changes in the heel area are rare and do not directly point to the heel spur. It can be a small swelling of the tissues in the heel area or the appearance of corns on it, which are unusual for this part of the foot. But the piercing pain in the heel says a lot and requires urgent therapeutic measures. Treating the calcaneal spur should be done without delaying the trip to the doctor in the long box until the disease has passed into a chronic form and did not cause a significant deterioration in the patient's quality of life or, worse, disability.

You are reporting a typo in the following text:
Simply click the "Send typo report" button to complete the report. You can also include a comment.