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Plantar calcaneal spurs and plantar fascial thickening This confusion is diagnosis was also the subject of a 2019 study ( 6 ) which suggested: Plantar calcaneal spurs and plantar fascial thickening frequently coexist in individuals with plantar heel pain. Tenderness on palpation of the heel has limited value for clinical assessment. Plantar heel pain is multifactorial and cannot be exclusively attributed to individual imaging findings. Simply, pain in the heel and imaging studies may not present an accurate picture of which is going on