What Is Calcaneal Spur ?
Plantar calcaneal spurs (PCS) are bony growths from the calcaneal tuberosity. PCS are usually described as bony growths that arise just anterior to medial to the calcaneal tuberosity.
Plantar calcaneal spurs (PCS) originate from the calcaneal tuberosity, located on the posterior plantar surface of the calcaneal bone. The majority of PCS arise from the medial side of the tuberosity, but they can also arise from the lateral side and sulcus. The shape of PCS is very variable, but is generally divided into two types, namely simple and irregular. Simple PCS is a triangular structure that tapers like a sharp point from a wide base. Irregular PCS has indistinct borders and no clear trabeculae.
Calcaneal spurs generally occur in several conditions, such as:
- Gout arthritis
- large BMI
- Plantar fasciitis
- Rheumatoid arthritis
- Osteoarthritis
- Ankylosing spondylitis
- Reiter’s disease
- Spondylarthritis
Causes of Calcaneal Spur
The etiology of acquired PCS is still not completely clear. It is traditionally hypothesized that PCS occurs through repetitive stress/traction of the Plantar Fascia or intrinsic muscles at their insertions on the calcaneus bone. This then leads to subsequent inflammation and triggers the development of a calcaneal spur.
Signs and Symptoms
Some of the signs and symptoms of calcaneal spur that are commonly felt are pain localized on the medial side of the calcaneal tuberosity. Pain is usually felt when walking. The pain felt can be due to pressure received by the foot or because of the inflammatory process that occurs.
Role of Physiotherapy in Calcaneal Spur
The main goal of PCS treatment is to relieve pain. The goal of physical therapy sessions is to reduce inflammation around the PCS. Some of the things that physical therapy does are:
- Leg muscle stretching exercises
Stretching the gastrocnemius and soleus muscles increases the range of motion of the dorsiflexion joint. This stretch reduces stiffness or lack of flexibility due to excessive pronation and overcompensation of the plantar fascia of the first metatarsal joint. This inflexibility also causes increased tension at the calcaneal insertion.
- Pain management
Physiotherapy will provide pain management using physiotherapy modalities, such as TENS. TENS is known to provide analgesic effects.
- Weight management
One of the risk factors for PCS is a high body mass index. This results in increased pressure on the plantar fascia. Losing weight is not only a conservative therapy, but also a preventive measure against the occurrence of calcaneal spurs.
- Education
It is important to educate patients about their condition. Because there is a possibility of activity limitations due to pain, the physiotherapist will provide education in the form of modifications to daily living activities and the use of assistive devices.
Also read: Memiliki Kaki Datar/ Flat foot/ Pes Planus, Berbahaya atau Tidak?
Reference :
- Kirkpatrick J, Yassaie O, Mirjalili SA. The plantar calcaneal spur: a review of anatomy, histology, etiology and key associations. J Anat. 2017 Jun;230(6):743-751. doi: 10.1111/joa.12607. Epub 2017 Mar 29. PMID: 28369929; PMCID: PMC5442149.
- Velagala VR, Velagala NR, Kumar T, Singh A, Mehendale AM. Calcaneal Spurs: A Potentially Debilitating Disorder. Cureus. 2022 Aug 28;14(8):e28497. doi: 10.7759/cureus.28497. PMID: 36185871; PMCID: PMC9514376.
- Physiopedia. Calcaneal Spurs. diakses melalui https://www.physio-pedia.com/Calcaneal_Spurs pada: 17 November 2023
- Bhawna Ujjainkar, Diksha Nagrale, Tushar Ubare, Shilpa Khurana, Shraddha Kawishwar. 2022. Role of Physiotherapy in Middle-Aged Patient with Calcaneal Spur – A Case Report. International Journal of Health Sciences and Research. Vol.12; Issue: 3. DOI: https://doi.org/10.52403/ijhsr.20220323
