Calcaneal spurs and plantar heel pad pain
One article on PainSci cites Onwuanyi 2000: Complete Guide to Plantar Fasciitis
PainSci notes on Onwuanyi 2000:
From the abstract: “Calcaneal spurs cause plantar heel pad pain, but the roles of other co-morbid factors are significant. The excision of these spurs does not necessarily abolish pain.”
original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
Calcaneal spurs may cause plantar heel pad pain. Their excision does not, however, abolish this pain. A number of co-morbid factors, such as increase in weight, advancing age, diabetes, elevated uric acid levels, and heel pad compressibility index, have been identified. This study evaluates 123 patients with calcaneal spurs and plantar heel pad pain in association with these factors.
METHODS: A prospective evaluation of 123 patients with calcaneal spurs in 136 heels and plantar heel pad pain in association with diabetes mellitus, body mass index>27, elevated uric acid and heel pad compressibility index, were matched with a control group of 141 patients (136 heels) without heel pad pain or co-morbid factors. This study was carried out between February 1997 and September 1999 in three hospitals. There were 91 females and 32 males in the study group, while the control group had 86 females and 55 males.
RESULTS: All patients in the study cohort presented with calcaneal spurs and plantar heel pad pain. The mean age for the males was 38.1 ± 2.4 and females 43.3 ± 0.8. 78.04% (96 patients) had body mass index (BMI) of over 27, in 48 patients (39.02%) uric acid levels were elevated above two standard deviations from the mean and 59 patients (47.96%) were diabetic, some with more than a single factor. The heel pad compressibility index of 0.54 ± 1.06 in males and 0.62 ± 0.02 in females of the study population was significantly greater than in the control population (males: 0.49 ± 0.4, females: 0.56 ± 1.8). The study and control groups were comparable with respect to age.
CONCLUSION: Calcaneal spurs cause plantar heel pad pain, but the roles of other co-morbid factors are significant. The excision of these spurs does not necessarily abolish pain. It is evident that heel pad compressibility increases with advancing age, weight gain, and diabetes mellitus, and contributes to the pathogenesis of plantar heel pain. This has an impact on the management of these patients, by de-emphasizing the role of surgical excision of these spurs.
related content
- “The instep plantar fasciotomy for chronic plantar fasciitis. A retrospective review,” W D Fishco, R M Goecker, and R I Schwartz, Journal of the American Podiatric Medical Association, 2000.
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- No long-term effects after a three-week open-label placebo treatment for chronic low back pain: a three-year follow-up of a randomized controlled trial. Kleine-Borgmann 2022 Pain.
- Exercise and education versus saline injections for knee osteoarthritis: a randomised controlled equivalence trial. Bandak 2022 Ann Rheum Dis.
- Association of Lumbar MRI Findings with Current and Future Back Pain in a Population-based Cohort Study. Kasch 2022 Spine (Phila Pa 1976).
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- Is Neck Posture Subgroup in Late Adolescence a Risk Factor for Persistent Neck Pain in Young Adults? A Prospective Study. Richards 2021 Phys Ther.