Background: Persistence of painful calcaneal spur (PCS) and loss of long-term effect may be related to unrecognized low back pain (LBP), dysfunction and/or lumbosacral radiculopathy (LSR), but prevalence of LBP in PCS patients has not been established. Purpose: to determine the prevalence of LBP among individuals with and without PCS. Methods: A cross-sectional study of individuals with (n = 26) and without (n=27) PCS. X-ray used to determine calcaneal spur. MRI and X-ray (as available), and clinical tests used to determine LBP/pathology/LSR. Results: A greater percentage of individuals with PCS had LBP (88.5% vs. 33% in controls), lumbar pathology (58 vs. 19), and LSR (54 vs. 15). Conclusion: Individuals with painful calcaneal spur had a greater prevalence of LBP/lumbar pathology/LSR. Treatment to address impairments related to lumbar spine may be necessary to enhance the treatment of PCS.