Painful Heel Lump or Bump on the Back of the Foot

Painful Heel Lump or Bump on the Back of the Foot

Painful Heel Lump:  90% of the time the cause of back of the heel pain are a a bone spur or achilles bursitis. Make 100% sure your Achilles heel pain stops!

There are two very common types of back of the heel pain.

Heel spur syndrome:

This involves bone spur formation at the bottom of the heel or the soul of your foot.

This is very frequently associated with the tightness of your plantar fascia, and this does that heel spur to form.

But this is on the bottom of your foot. Not where your Achilles tendon inserts.

Plantar Fascia Foot Pain
If the pain is at the bottom of the heel, then suspect plantar fasciitis!

Insertional Achilles tendinitis:

Painful Heel Lump or Bump on the Back of the Foot
A heel lump or bursitis can lead to Achilles tendinitis.

If you have found your way to this page, this is likely the type of pain that you are thinking about.

This can be classified by a few different names. There are numerous overlapping problems that can contribute to insertional Achilles tendinitis.

These are known as a Haglund’s bump, heel spur bursitis, Achilles fat pad inflammation, insertional   Achilles tendon spur, and it does go by many other different names. Spur can also be called an enthesophyte.

What can cause a painful heel lump or bump?

The most common causes of creating a heel lump or bump are the swellings associated with insertional Achilles tendonitis.

Insertional Achilles tendinitis inserts into the back of the heel bone. This is where the Achilles tendon connects your big thick calf muscle into the back of the heel bone. A bone spur can gradually develop around the tendon where inserts into the bone.

Think about the heel spur and thickening as a gradual ripping out of the bone heel bone. Your calcaneus bone is trying to heal but it almost gets stretched out along with the tendon as a few years go by, this eventually looks like a spur has formed.

This spur formation process usually takes many months or many years to develop. When we go to the site surgically, it looks more like a hard sand rather than thick spiky bone. So don’t get too scared just yet! It does not always mean that you need some type of surgery.

Yes it is true that a bone spur is associated with Achilles tendon damage, the bigger the spur means usually more tendon damage and pain.

The inflamed and damaged insertion of the Achilles tendon can be calcified hard bone. But this can also cause the Achilles fat pad to become inflamed. This can also be called back of the heel bursitis.

What is a painful back of the heel lump or bump associated with?

Insertional Achilles tendinitis is usually associated with tightness through your hamstring muscles in your calf muscle.

Yes it is true that the older you get, the stiffer your tendons in your joints generally tend to get. People who are usually in their 40s, 50s and 60s tend to have more stiffness especially with a high workload. I see this most commonly with people who spend the majority of the day standing.

Achilles tendinitis usually develops gradually over years or decades and it is not linked with a single injury.

Running and jumping can significantly make the back of your heel pain worse.

People usually feel it while walking up and down the stairs or standing on hard concrete a good portion of the day.

The more activity you do the more pain and inflammation you will have.


Home treatment of back of the heel pain:

Why Achilles Heel Spur Insertion Pain is So Hard to Treat:

Why heel spur insertional pain is hard to treat? Everybody treats this differently and doesn’t really take it all that seriously as a non-surgical treatment method. They see a very large thick spur or bone build up and assume that they must remove it surgically.

Some people treat this disorder by stretching, some people are treated by ultrasound and massaging, and some people do it by  physical therapy techniques alone. Let me tell you it is possible to fix it without surgery!

The bottom line though is most people never let inflammation cool down. People continued to stay stiff and painful while doing every other possible treatment method. Tthey continue going to work every day, and they continue trying to power through it and walk or run. No pain no gain does not work here! Pain just causes it to stick around forever.

The key is understanding why you are getting this in the first place. You must understand the mechanism of action.

Fix the reason why you get insertional Achilles pain.

Yes. Your Achilles tendon is too tight, but stretching is not really what fixes it in a practical level for most people. Look at the picture here.

Back of the heel pain achilles tendon insertion

Whether the tendon is too tight or not is not the problem it’s how compressed the Achilles tendon gets against the back of the heel.

You have to find a way to keep the heel bone from tilting up so much and pressing the Achilles tendon against the back of the heel bump. When it’s loaded, the calcaneus gets turned up and out. This twisting is when the bone rubs against the Achilles tendon the most.

Stretching does help but it doesn’t fix the problem completely.

Once you understand this concept you will understand why it happens, think about it is a rope going along the tree and you pulling against that rope.

We have to find a way to get that bone to stop rubbing against the  Achilles tendon. A lot of the times it’s by lifting up the heel bone, or getting rid of that top of the bone spur.

An orthotic and shoe is a good way to do this long term, not stretching. But this only works if the tendon cools down from swelling first.

The practical home treatment plan for your painful heel lump or bump:

 Step 1: Let inflammation cool down.

Find a way to relax the back of your heel so you’re not walking all day.

This can be tough if you weigh 300 or 400 pounds, or stand on concrete for 12 hours a day. But if you’re a runner or something that can be controlled, take a break from running.

Switch to biking, swimming and upper body weight lifting for a few weeks or months.

This is where icing and anti-inflammatory creams can be good.

I’m not a huge fan of taking pills to solve this problem, it is not a permanent solution.

Step 2: Find ways to take pressure off it:

The best way to do this is to find great shoes.

Great shoes are then best combined with great orthotics.

Sometimes a lace up ankle brace may be needed if the first two options don’t work. Usually with these three things you can take an amazing amount of pressure off it.

The key is to actually wear them. Wearing these devices during dinner and walking barefoot for the other 23hrs of the day won’t fix the problem.

For some people if the pain is bad, they may need a cast or boot for at least a few weeks.

Go see your podiatrist and get an x-ray of your heel if you think something might be broken, even a pair of your Achilles tendon may need it an ultrasound or an MRI.

Step 3: Fix the underlying problems:

If this truly is a life altering condition that you have a hard time fixing, make some of the tough choices.

For example, I can guarantee you if you were a computer programmer and weighed 100 pounds, there is almost no chance that you would have Achilles tendinitis.

But if you weigh 300 pounds and work on a factory floor 16 hours a day, there’s about a 95% chance that you will have knee arthritis, Achilles tendinitis, hip and back pain. One of these is guaranteed.

The problem we run into the clinic is we have a lot of the second type of patient who is asking us to fix their problem while they keep working and while they don’t really want to commit to losing weight.

I’m not saying you must meet all these tough criteria, but even losing 5 to 10 pounds can take a significant amount of pressure off your feet. Because the important thing is once you heal this problem, you don’t want it to ever come back.

There is no doubt about it Achilles tendon nice takes forever to get better, so give it a chance for a few weeks or months, and then correct the reasons that cause that to happen in the first place.

Other Causes Of A Painful Back Of The Heel Lump:

1) Back Of The Heel Bone Formation:

  • A lump or bump at the back of the heel is  a Haglund’s bump.
  • It can also be called an enthesopathy: this means calcification of the Achilles tendon.
  • This is basically excess bone that forms over time due to improper rubbing and biomechanics.
  • This is especially likely in females that wear improper shoes like flats or high heels.
  • This excess bone formation of bone at the back of the heel can put pressure on the soft tissue.
  • This will eventually lead to irritation and inflammation in the area.
Painful Heel Lump or Bump on the Back of the Foot
A painful heel lump or bump is known as a Hagland’s bump, this can be very painful!

2)Back Of The Heel Bursitis:
  • There are two gel-like pouches on the inside and on the outside of your Achilles tendon.
  • These pouches  are known as bursa.
  • The normal function of the bursa is to provide a lubricated surface for the Achilles tendon to slide.

  • It should allows the tendon to slide between the bone and the skin.
  • If one of these get inflamed or damaged you can get a condition known as bursitis.
Who Gets A Back Of The Heel Lump Or Bump:
  • The most likely demographic to be affected are females aged 20-30 years old. This is when a Haglund’s bump is most noticed.
  • Especially those who wear high heel shoes.
  • It is more likely in people with a high arched foot.
  • Those who frequently have friction against the back of their heel.
  • But It can happen to anyone.
Back Of The Heel Lump Or Bump Symptoms:
  • Can be fast on setting pain or very gradually on setting pain.
  • Pain that hurts before motion and starts to get better as you move around more.
  • The back outside of your heel is painful.
  • Achilles tendon insertion pain is likely.
  • Inflammation and redness likely in the skin.
Painful Heel Lump X-rays:
  • Large bump on the upper outside of your heel (Haglund’s deformity).
  • Calcification of the insertion of the Achilles tendon.
  • Soft tissue swelling (bursitis).
  • Rule out any damage to the Achilles tendon.
  • Rule out any heel spur.

Treatment Guide

Here is the guide on how to handle a Haglund’s bump in 3 easy steps:

Stage 1: Conservative Treatment

Stage 2:  Extensive Conservative Treatment or Surgery

Stage 3: Surgery

Other Back Of The Foot Pain Causes:

1)Achilles Tendinitis:

  • If the pain appears more slowly and you cannot physically feel a bump on the back of your foot.
  • Suspect Achilles Tendinitis.

2)Plantar Fasciitis :

  • Suspect this if the bottom of your heel is hurting.
  • Suspect this if your arch is also hurting.
  • This is the most common cause of heel pain.

3)Tarsal Tunnel Syndrome:

  • Suspect these if you have numbness burning or tingling.