Definition
As heel spur (Kalkaneussporn), one calls a bony outgrowth (spur) at the heel bone (Calcaneus). This thorn-like outgrowth can grow in the direction of the sole of the foot, which is then by definition called “plantar calcaneal spur” and is the most common form of heel spur. Rarely the spur can also appear along the Achilles tendon and is then called “dorsal calcaneus spur”.
Approximately ten percent of adults in Germany develop heel spurs during their lifetime, which makes them a very common clinical picture. A general cause for the development of a heel spur is considered to be an overload of the structures involved: Excessive or incorrect strain on the foot causes tiny cracks and injuries at the site between the heel bone and the attaching tendon, which can result in inflammation. The body reacts by remodelling the tissue to adapt to the increased stress and tries to counteract the overloading by calcification and ossification, which causes the spur.
A risk factor for foot overload is the shortening of the calf muscles, which results in increased traction on the heel bone and thus in excessive strain. Overweight or malpositioning of the foot, for example a kink-lower foot, also contributes to the development of heel spurs through incorrect loading. Sports that put a lot of strain on the foot, such as running, also represent a risk factor for heel spurs.
Even without incorrect loading, heel spurs can occur due to a hereditary predisposition. An unavoidable risk factor for heel spurs is age: Here the shock-absorbing fat pad under the heel becomes smaller, resulting in increased stress on the bone. In this case, the heel spur is a wear-related, i.e. degenerative, disease.
Symptoms
Typical symptoms of heel spurs are pain when standing and walking, especially on the sole of the foot, but also on the heel itself. The pain is severe and has a stabbing component. The heel spur pain is also characterized by its disappearance when relieved and its increased occurrence during stress after rest periods such as in the morning after getting up in the morning.