Question
A doctor once indicated in a statement that pes planus was caused by plantar calluses and corns and he was board certified. I have the condition and my research concluded that what he stated was not a true medical fact. So I have been told by a doctor that heel spurs are not a condition related to pes planus or plantar fasciitis. So my question is what causes heel spurs / calcaneal spurs.

Answer
Hi, Antoine,

Thank you very much for your question.  I apologize for the delay in my response and for the confusion about the question.  I think of heel spurs are your body's way of reinforcing an area where there is extra pull, in this case where the plantar fascia attaches to the calcaneus.  Think of the plantar fascia as a heavy painting and your heel bone as the wall that the painting hangs on.  Sometimes you need some sort of anchor to help hold that painting in place....hence the spur.

In truth, there can be several causes for a calcaneal spur, and there is no simple answer to your question...nor do we entirely know.  Basically, any explanation is more a theory than an actual medical fact.  It would be very difficult, if not impossible, to find a humane and ethical way to artificially create heel spurs, so we try to understand and explain it as well as we can.  In addition, there doesn't seem to be one single cause for heel spurs.  There are several situations that we suspect have a part in the formation.  

The spur sometimes forms because of the mechanics of the way you walk, sometimes because of irritation or inflammation or micro (tiny) tears in the area where the plantar fascia attaches to the calcaneus, sometimes because of a rheumatological condition that causes extra deposits of calcium in certain areas of your body, and sometimes we don't even know the reason.  

I have patients with cavus (high-arched) feet and calcaneal spurs, patients with pes planus (flat feet) and spurs, and even patients with neither a high nor a low arch (rectus foot type) who have heel spurs.  I also have patients with plantar fasciitis who do not have spurs, and patients with spurs who have absolutely no pain whatsoever.  The spur itself, as I tell patients, doesn't tell us much.  It's easy to see on X-rays, and there tends to be a lot of talk about it, but when treating foot conditions, it doesn't have much of a role in my decisions about a patient's condition or what is needed to help him/her feel better.

I hope this helps shed some light on a very complicated and poorly understood topic.  Thank you for giving me this opportunity to provide some insight and hopefully dispel a few myths about heel spurs.  I also appreciate that you took the time to clarify your question and patiently awaited an answer.

Wishing you health, happiness, and peace,
Dr. Bodart