A Comparative Study of Heel Spur Incidence in Patients with Painful Heels and General Population Over Forty Years

Inferior heel pain is a common complaint in patients referred to orthopedic clinics. Etiology of this pain is unknown, but one of the suggestible causes is heel spur. The present descriptive comparative cross-sectional study was undertaken to evaluate the prevalence of heel spur in patients with painful heels and compare it with general population in order to determine spur role in this pain. Patients & 625 lateral X-rays of heel including 427 X-rays of general population(age>40yrs) and 198 X-rays of patients with painful heels(age>40yrs) were evaluated. The prevalence of heel spur was 33.02% in general population and 79.79% in patients with painful heels, which was suggestive of a significant difference(P=0.000, X2=131.570). The prevalence of spur increased with age in the painless group but not in the painful group. Heel spur was significantly more common in women than men in the painless group(40.9% versus 22.8%, P=0.001). Mean spur length was 6.5536±2.3658mm in the painful group and 5.3672±2.5683mm in the painless group revealing a significant difference(P=0.004). No significant difference was found between two groups regarding spur angle. Based on the obtained results, it can be concluded that spur may not be considered as a causative factor of pain but it can be a predisposing factor for heel pain. Another conclusion would be that pain and spur could have common pathogenesis.