Evolution And Clinical Effectiveness Of Surgical And Conservative Methods In The Treatment Of Calcaneal Exostoses

Calcaneal spur, a bony outgrowth at the attachment site of the plantar fascia, is one of the main causes of chronic heel pain and is frequently associated with plantar fasciitis. Despite its prevalence, the clinical and pathological significance of the spur remains controversial. This study reviews the evolution and clinical effectiveness of both surgical and conservative treatment approaches for calcaneal spurs, based on recent literature data. An analytical review of key studies was conducted, evaluating the outcomes of endoscopic plantar fasciotomy, minimally invasive spur resection, and conservative modalities such as shock wave therapy, ultrasound therapy, and low-dose radiotherapy. Evidence suggests that endoscopic and minimally invasive surgical methods reduce operative trauma and enhance postoperative recovery. However, the calcaneal spur itself is not always the primary pathological factor; rather, inflammation and tendinopathy of the plantar fascia play a more significant role. Conservative methods, particularly ESWT and low-dose radiotherapy, have proven effective in pain reduction and inflammation control. Treatment of calcaneal spurs should be individualized, taking into account the condition of the plantar fascia and the morphology of the spur. In modern clinical practice, the calcaneal spur should be viewed not as an independent disease, but as a morphological manifestation of plantar fasciitis.

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