Calcaneal spur (calcaneal spur, calcaneal spur, fasciitis plantaris/fasciitis plantaris; ICD-10-GM M77.3: calcaneal spur) refers to a thorn-like exostosis (bony outgrowth, toe-oriented) of the calcaneus.
Although the calcaneal spur gives its name, it is not causative of the accompanying heel pain. Heel pain is usually caused by an underlying inflammatory disease of the plantar tendon or Achilles tendon insertion.
Depending on the location of the heel spur, two forms can be distinguished:
- Lower (plantar) calcaneal spur (= plantar calcaneal spur) – ossification in the attachment area of the small foot muscles on the underside of the heel bone (plantar aponeurosis → plantar aponeuritis or plantar fasciitis (PF): inflammation of the tendon plate of the sole of the foot); most common form.
- Upper or posterior (dorsal) heel spur (= Haglund heel or Haglund exostosis) – ossification at the petrous bone attachment of the Achilles tendon.
The heel spur is one of the common foot diseases.
Frequency peak: the disease occurs predominantly between the 40th and 60th decade of life.
The prevalence (disease frequency) is about 10% (in Germany). In active runners, a prevalence of 5.2-17.5% has been determined.
Course and prognosis: A heel spur can also exist for a long time without causing complaints. Irritation leads to inflammation of the plantar fascia (plantar fasciitis) and resulting pain. If left untreated, inflammation leads to increased ossification, which can further worsen the condition and make it chronic. Normal rolling when walking is then no longer possible. The prognosis is better the earlier therapy is started. Early therapy prevents the patient from remaining physically inactive for weeks or even months due to pain. Thus, pain relief can be achieved in more than 90% of patients within the first six months.The disease is considered self-limiting: in 80 to 90% of cases, symptoms resolve within one year, regardless of therapy.The heel spur can be recurrent (recurring).
