A lump on the back of the heel bone

A lump at the back of the heel bone is often a bony protrusion. This is also known as Haglund’s exostosis. The bony protrusion is usually located close to the attachment of the Achilles tendon.

The lump itself does not always have to be painful. Symptoms mainly occur when a shoe presses on it or when the bursa or Achilles tendon becomes irritated.

A lump on the back of the heel is often caused by prolonged pressure or friction on the heel. This can cause the area to become increasingly sensitive or swollen.

Possible causes are:

• constitution or foot shape;
• shoes with a hard heel edge;
• a flat foot or high instep;
• doing a lot of sport or walking;
• stiff calf muscles;
• Achilles tendon complaints;
• an abnormal gait pattern;
• prolonged pressure on the back of the heel.

The symptoms are located at the back of the heel. The area may feel hard, appear red or be tender.

You may notice that:

• there is a distinct lump on the back of the heel;
• shoes cause pressure pain;
• the skin becomes red or warm;
• swelling occurs due to an irritated bursa;
• walking or exercising causes pain;
• the Achilles tendon can also be sensitive.

Getting enough exercise is important, but it is also important to minimise pressure on the back of the heel.

Gradually building up your walking or exercise routine and allowing sufficient time for recovery can help to reduce heel pain. Wearing good shoes that put less pressure on the sensitive area is important in this regard.

Sleep, diet and a healthy body weight can also contribute to better recovery and reduce strain on the feet. Pain or pressure in shoes can be frustrating and affect how much you move around.

Our lifestyle coaches can support you with changes relating to sleep, diet and weight that are suited to your situation.

There is a lot you can do yourself to reduce the pressure on the lump.

To reduce symptoms, you can:

• avoid shoes with a hard or constricting heel edge;
• choose shoes with enough room around the heel;
• temporarily adjust the sports tax;
• no redness or tenderness on palpation;
• check the skin for irritation or cuts;
• Please contact us or your GP if the swelling increases rapidly.

Our podiatrists We examine the location of the lump, the shoes you are wearing and your gait. We look at how pressure and friction can be reduced.

Treatment may consist of:

• shoe advice;
• temporary pressure relief;
• orthopaedic insoles to improve weight distribution;
• advice on adapting shoes;
• ultrasound examination;
• exercises or working with a physiotherapist for Achilles tendon problems.

If the symptoms persist despite treatment, it may be necessary to consult your GP. Sometimes an assessment by another healthcare professional is required.