How can I get rid of a bony lump at my heel area?

A prominent bony bump at the posterior heel area, is often a combination of several pathology. The GP is right that it could be insertional Achilles tendinits. Sometimes there is additional calcific deposits in this region from the chronic inflammation, and that lead to pain and swelling as well.

A Haglund's deformity is a prominent calcaneal spur that abuts the Achilles tendon and causes pain. And finally, a retrocalcaneal bursitis can add on to the symptoms. This would be located between the Achilles tendon and the Haglund's deformity. Together, all three pathology is collectively known as Haglund's Syndrome.

It rarely goes away, especially if there is a calcaneal spur. As that is actually "additional bone", it won't disappear on its own. Achilles tendinitis or retrocalcaneal bursitis may settle down if treated properly. It would be important to visit an orthopaedic surgeon, and some investigations may be necessary to diagnose the problem and see how severe it is.

Treatment would then be tailored to the problem. This may be conservative, with medication and physiotherapy. Sometimes surgery may also be indicated, especially if the bump is a large one, and conservative treatment fails.

It is a very treatable problem, so I would advise you to seek a consultation soon, if it bothers you. Hope the above information is useful.

Best regards

Dr Sean Ng

The main question that comes to mind is "is it a problem?". You see, we often have differences from one body part to another but they may not be symptomatic.

Common symptoms from an Achilles insertional tendinopathy or Haglund's deformity include pain, swelling, redness, stiffness and an aching sensation with prolonged activity.

There also might be pain associated with the bursa that Dr Sean has mentioned together with discomfort when wearing shoes.

If the area is symptomatic, there are a few steps to consider:

1. An ultrasound scan of the tendon to assess the bony lump, determine if there are any tears or inflammatory changes around the tendon or if there is a bursa

2. Consider physiotherapy as often there is an element of hamstring or calf tightness

3. Consider shockwave therapy, which can help break down calcific changes that occur in the tendon, although it may be of less benefit in a Haglund's deformity.

4. If there are tears in the tendon or a painful bursa, you could consider a PRP or prolotherapy injection - a number of patient who have done well after this and are back to normal activity

5. If the symptoms are ongoing despite all these conservative treatments, perhaps consider a surgical intervention

Hope this helps you plan out your treatment a little bit better. I would suggest seeing a Physiotherapist or a Sports/MSK physician in the first instance - they can assess you clinically and investigate as appropriate.

BW
Dr Dinesh