title: Calcaneal spurs: examining etiology using prehistoric skeletal remains to understand present day heel pain.
abstract: BACKGROUND
  Calcanei are the most common sites for bony spurs. Although calcaneal enthesophytes have been extensively researched, many unknowns remain. Whether biological factors, such as age, weight and genetics, play a greater role in calcaneal spur etiology than activity is still unknown.
  
  
  OBJECTIVE
  The current study examines 121 adults from a prehistoric hunter-gatherer population to aid in understanding bony spur etiology.
  
  
  METHODS
  Calcaneal spurs are scored as present or absent on the dorsal or plantar side; they are analyzed in regards to their relationships with age, sex, osteoarthritis, cortical index, femoral head breadth and muscle markers.
  
  
  RESULTS
  Dorsal and plantar spurs frequencies increase with age (chi-squares=16.90, 7.268, Ps<0.05, respectively). Dorsal spurs were more frequent than plantar spurs (chi-square=38.000; P<0.0001). There is a positive relationship with calcaneal spurs and upper limb and lower limb osteoarthritis (chi-squares=5.587, 7.640, Ps<0.05, respectively).
  
  
  CONCLUSIONS
  The data presented support that dorsal spurs are in part the result of activities, but plantar spurs may be a more modern phenomena resulting from long periods of standing and excess weight.
authors.affiliation: Anthropology Department, San Jose State University, San Jose, CA 95192-0113, USA. Elizabeth.Weiss@sjsu.edu
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Weiss
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000885:Anthropology, Physical; D050280:Arm Bones / Q000473:pathology; D002111:Calcaneus / Q000473:pathology*; D005260:Female; D005269:Femur / Q000473:pathology; D036982:Heel Spur / Q000209:etiology / Q000473:pathology*; D049690:History, Ancient; D006801:Humans; D008297:Male; D010003:Osteoarthritis / Q000473:pathology; D054850:Osteophyte / Q000473:pathology; D010146:Pain / Q000209:etiology; D013977:Tibia / Q000473:pathology; D055815:Young Adult