Pain in the back of the heel is a common complaint and can be caused by various conditions. The most common causes of this type of heel pain are Achilles tendinitis, retrocalcaneal bursitis, and Haglund’s deformity.
Let’s explore each of these causes, their diagnosis, and treatment options:
1. Achilles Tendinitis:
– Causes: Overuse or repetitive stress on the Achilles tendon, which connects the calf muscles to the back of the heel bone. It can be triggered by activities such as running, jumping, or sudden increases in physical activity.
– Diagnosis: Typically, a medical professional will perform a physical examination of the foot and ankle, inquire about the patient’s activities, and may order imaging tests like an ultrasound or MRI to confirm the diagnosis and assess the severity of the condition.
– Treatment: Treatment usually involves rest, avoiding activities that exacerbate the pain, and using ice to reduce inflammation. Physical therapy may be recommended to strengthen and stretch the calf muscles and Achilles tendon. In some cases, orthotics or heel lifts can help relieve stress on the tendon. Severe cases may require immobilization with a walking boot, and in rare cases, surgery might be considered.
2. Retrocalcaneal Bursitis:
– Causes: Inflammation of the bursa, a small fluid-filled sac located between the Achilles tendon and the heel bone. It is often caused by repetitive friction or pressure, such as wearing ill-fitting shoes.
– Diagnosis: A medical professional will evaluate the symptoms, conduct a physical examination, and may order imaging tests like an X-ray to rule out other conditions and confirm the diagnosis.
– Treatment: Treatment involves rest, avoiding activities that worsen the pain, and using ice to reduce inflammation. Properly fitting footwear and cushioned heel pads can help alleviate pressure on the bursa. Physical therapy to improve flexibility and strength may also be recommended. In some cases, a doctor may use corticosteroid injections to reduce inflammation.
3. Haglund’s Deformity:
– Causes: Also known as “pump bump,” Haglund’s deformity is a bony enlargement at the back of the heel bone. It can be caused by the constant pressure and rubbing of rigid-backed shoes against the heel.
– Diagnosis: A medical professional will perform a physical examination, inquire about the patient’s footwear choices, and may use imaging tests like X-rays to confirm the diagnosis and assess the severity of the condition.
– Treatment: Treatment includes wearing open-backed or soft-backed shoes to reduce pressure on the heel, using ice to reduce inflammation, and over-the-counter pain relievers. In more severe cases, a doctor may recommend physical therapy, orthotic inserts, or in rare instances, surgery to remove the bony prominence.
It’s essential to seek medical advice if you experience persistent or worsening pain in the back of the heel. A healthcare professional can accurately diagnose the underlying cause and recommend the most appropriate treatment plan for your specific condition.