Calcaneal spur

We assume different triggers for this disease:

Foot orthotics in the area of the calcaneal spur that feature a notch and care for a decompression of the tender location. This notch normally has a foam cushion. In addition, with these foot orthotics the longitudinal arch of the foot must be braced as the cushion of the calcaneal spur alone most often is not enough. The industry is offering silicone cushions that are looking quite nicely but rarely do the trick. On the other hand this can by far be not any different from that because this insufficiently patient- fitted “blanks” cannot be individually produced by the industry. It turns out to be beneficiary to fit the foot orthotics in the strongly footstep noise damping running shoe. In advance, the original sole of the shoe should be removed.

Physical therapy where the tendon of the calf and the sole of the foot are stretched.

Foot orthotics for the correction of an existing fale position of the foot (flat foot, splayfoot)

Local treatment by application of cold (ice massage) is having a pain-relieving, antiphlogistic and decongestant effect. It is easy to apply at home and in self therapy. Put a yogurt pot together with a plastic spoon into the fridge. After 3 to 4 hours by means of this big icy pole the sole of the foot, the ankle and the heel can be scrubbed. However, not freeze too long on one place and do not extend the ice massage to durations longer than 10 minutes. The procedure shall be repeated every two to three hours. Eventually some stretching can be made in advance.

Cortisone injections, which are extremely painful as the foot soles are highly sensitive. In the course of these injections the muscle attachment is infiltrated with a medication mixture out of local anaesthetics and adrenocortical steroids having a antiphlogistic and analgesic effect. Partially it is recommended a dosage of three injections. The practical effect of these injections is often very limited. There is a danger of remaining tissue alterations on the foot sole that can bring along an increase in pain.

Operation: By means of an incision at least on side of the foot the calcaneal spur is being chiselled off. In addition, nerves can be cut through and the normally inflamed synovial bursa can be removed. Idle period is approximately 2 to 4 days long; afterwards the tendon must be disburdened by the use of special shoes with additional foot orthotics. The usage of this orthotics can be decreased step by step after approximately 6 weeks of usage. In not so complicated cases it is possible, if necessary, to have an operation on both feet. In more severe cases the operated feet has to heal up before the other feet can get operated because an exposure of the operated feet is apriori not possible. Often these operations lead to another source of pain in addition to the calcaneal spur: the pain of the cicatricial tissue.


Antiphlogistic medications: Mostly so-called (NSAID=non-steroid-anti-inflammatory-drugs) are used, that have an antiphlogistic, antipyretic and detumescent effect. The most observant side effects of these medications are gastro-intestinal disorders that are initially shown in the form of complaints in the upper abdomen.

Extracorporeal shock-wave therapy (ESTW): The use of high-energetic focussed shock waves is said to alleviate the chronic pain but the mechanism of action is still unexplained. The costs for the procedure have to be carried by the patient himself or herself. Some (private health) insurances absorb the costs on application if all conventional treatment methods have been exhausted. The costs per one application are about EUR 400 (03-2007).

Radial shock-wave therapy: It is a more cost-saving alternative to the ESTW therapy. This therapy is less focussing and with a less infiltrating effect. As against the ESTW therapy this therapy is obviously paid by many health insurances. It is recommended that three to maximum five shock-wave therapy treatments for example with 9 hertz (= 9 impulses per second) are to be made with approximately 2.000 impulses. There are different power levels of the shock waves and also different frequencies adjustable at the respective appliance. The scale of some appliances goes from 0,5 bar up to 4,0 bar. The pulse intensity is adjusted to the only just bearable pain intensity of the treated patient. Some patients feel that only an intensity of 0, 5 bar is painful. The treatment shall lead to an increased metabolism and to a resorption of calcareous deposits in the tendons. If necessary, the patients are also given a local anaesthetic.

Cross-friction massage after Dr. James Cyriax (= intermittent (sporadic) massage on the muscle-tendon junction) if necessary, alternating with applying an ice-bag as well as earlier heat treatment, medical electrotherapy or laser therapy. By means of all these therapy steps the inflammations as well as the vaulted oedema shall be eliminated.

Pain therapy by means of X-ray therapy (also called stimulating X-ray therapy or inflammation radiation) of the respective area of the body in mostly 4 to 6 applications. Electronic beams or photon beams are applied with this therapy respectively X-radiation with a higher energy level. When it comes to the classical X-ray therapy starting with a level of 150 keV for some years increased by catalyst equipped appliances (X-ray treatment centres) with energy levels of 4 to 6 MeV. Every treatment lasts only about 20 to 40 seconds and the therapy is totally pain-free. In numerous studies a response sensitivity of 80% of all patients could be verified. The health insurances pay fully for this medical treatment.

Acupuncture: When it comes to patients suffering from calcaneal spur this kind of therapy is described as very painful but with some patients a improvement of the pain caused by the calcaneal spur is achieved.