Multimodal Physiotherapy for Calcaneal Spur: A Case Report

Abstract

Background: Calcaneal spur is a bony outgrowth commonly associated with plantar heel pain, leading to functional limitations in standing and walking. Multimodal physiotherapy combining electrotherapy and exercise has been widely used; however, evidence from detailed clinical case reports remains limited.

Objective: To evaluate the clinical effectiveness of a multimodal physiotherapy program in reducing pain and improving functional ability in a patient with calcaneal spur.

Methods: This case report describes a 54-year-old female with left calcaneal spur who underwent six physiotherapy sessions over three weeks in an outpatient rehabilitation setting. Interventions included therapeutic ultrasound (1 MHz, 1.2 W/cm², 5 minutes), conventional transcutaneous electrical nerve stimulation (TENS; 80–100 Hz, 15 minutes), and structured exercise therapy (stretching, strengthening, balance, and gait training). Outcomes were assessed using the Numeric Rating Scale (NRS) for pain, ankle range of motion (ROM), and the Foot and Ankle Disability Index (FADI) for functional ability.

Results: Pain intensity decreased from NRS 5 to 2, indicating a clinically meaningful reduction. Ankle dorsiflexion improved from 15° to 20°. Functional ability increased substantially, with FADI scores improving from 52% to 90% (absolute improvement: 38%). Clinically, the patient demonstrated improved gait pattern and reduced pain during weight-bearing activities. No adverse events were reported.

Conclusion: A structured multimodal physiotherapy program demonstrated clinically meaningful improvements in pain, joint mobility, and functional performance in this case. These findings highlight the potential benefit of combined interventions; however, further studies with larger samples and long-term follow-up are required.