Severe discomfort in the back of the heel may indicate the presence of a calcaneal or Achilles tendon spur, which according to the American College of Foot and Ankle Surgeons, ACFAS, is known as Haglund's Deformity. The spur is a calcified protrusion, also known as a "pump bump" because it is located where shoes may excessively rub the heel. Causes of this painful syndrome range from heredity to a tight Achilles tendon. Posterior heel spurs often respond positively to conservative treatment such as ice and stretching. Acute or chronic cases sometimes require steroid injections or surgical removal of the spur.
R.I.C.E. Treatment
According to Achilles Foot Health Centre, the initial treatment for a posterior heel spur is the standard sports medicine approach of rest, ice, compression and elevation commonly known as R.I.C.E. therapy. For short term acute flare-ups, the R.I.C.E. method can help alleviate pain and decrease inflammation around the Achilles tendon. The ACFAS recommends to reduce swelling by applying an ice pack on top of a thin towel, which you place directly on the skin for about 20 minutes. Wait 40 minutes before icing again. Compression can be achieved by taping the ankle or by using drugstore ankle wraps or braces.
Orthotic Devices
Orthotic devices such as customized arch supports, heel pads, lifts or cups may all help decrease pressure on the heel and decrease pain. Pads placed inside the shoe may reduce the irritation on your heel while walking. Lifts or arches may help control motion of the foot and also alleviate excess pressure on the heel.
Physical Therapy and Exercise
Stretching exercises that focus on lengthening the Achilles tendon can be helpful, especially for people who have an overly tight heel cord. Lean against a wall with both arms extended, place one foot directly in front of the other while pressing your back leg heel to the floor to effectively stretch your Achilles and calf muscle. A physical therapist or podiatrist may recommend ultrasound therapy to reduce inflammation and promote healing of the surrounding soft tissue.
Medication and Modification
Your physician may recommend anti-inflammatory medication, such as ibuprofen, to lessen painful symptoms and reduce swelling around the spur. In addition to resting, icing, stretching and ibuprofen, you may require a change of shoes to decrease the irritation on the heel. Backless shoes or footwear designed with a soft back may be more appropriate and help minimize friction and irritation to the posterior heel.
