What causes heel spurs?

From the Guidelines

Heel spurs are primarily caused by repetitive load to the heel, leading to stress fracture of the calcaneus, most commonly just posterior and inferior to the posterior facet of the subtalar joint. This is supported by a study published in the American Family Physician in 2002 1, which highlights the importance of repetitive load in the development of heel spurs. The main factors contributing to this repetitive load include:

• Improper footwear
• Excessive walking or standing on hard surfaces
• Obesity
• Abnormal walking patterns that place extra stress on the heel
• Age, as the protective fat pad on the heel thins over time
• Certain activities like running and ballet dancing
• Structural foot problems such as flat feet or high arches
• Medical conditions including reactive arthritis and ankylosing spondylitis

It's worth noting that while another study published in 2005 1 discusses Achilles tendinopathy, which can also cause heel pain, it does not directly address the cause of heel spurs. Therefore, the 2002 study 1 remains the most relevant and highest quality evidence for determining the cause of heel spurs. The development of heel spurs is a complex process, but repetitive load to the heel is the primary underlying factor, and addressing this factor is crucial in preventing and managing heel spurs.

From the Research

Causes of Heel Spurs

Heel spurs are bony projections that form around the calcaneal bone, and their development is often associated with various factors, including:

• Repetitive strain of the fascia at its attachment to the heel bone 2
• Increasing body weight 3
• Certain diseases, such as arthropathies, Gout, pes cavus, and pes planus 3
• Lifestyle and occupation 3
• Age and gender 3

Relationship with Plantar Fasciitis

Heel spurs are often seen in association with plantar fasciitis, a condition characterized by inflammation of the plantar fascia 2, 3, 4, 5, 6. The exact relationship between heel spurs and plantar fasciitis is not fully understood, but it is believed that the repetitive strain on the plantar fascia can lead to the formation of heel spurs.

Risk Factors

Certain factors can increase the risk of developing heel spurs, including:

• Prolonged standing or walking 3
• Wearing poorly fitting shoes 3
• Having a job that involves standing or walking for long periods 3
• Being overweight or obese 3
• Having certain medical conditions, such as arthritis or gout 3