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What Can Lead To Posterior Calcaneal Spur. A heel spur is a hook of bone that can form on the heel bone of the foot. Heel spurs are associated with plantar fasciitis. Heel spurs can cause extreme pain in the rearfoot. The pain is most intense while standing or walking. What Causes Heel Spurs? Surgery is used a very small percentage of the time. It is usually considered after trying non-surgical treatments for at least a year. Plantar fascia release surgery is use to relax the .