Pain on the Back of the Heel

Retrocalcaneal Exostosis

Also known as a "pump bump" or "Haglund's deformity", is a painful bony spur on the back of the heel can become a nuisance to anyone who wears shoes. Some patients can develop a bony spur on the back of the heel or calcaneus where the achilles tendon attaches. At the site of the spur, the achilles tendon and surrounding tissues can become inflamed and very tender. Also, in chronic cases, portions of the achilles tendon can become thickened and calcified or essentially turn to bone when repeatedly irritated by the spur. This part of the foot also tends to significantly rub on the back of the shoe causing increasing pain with more friction and motion that occurs. Most people often have relief when wearing flip flops, clogs or any other open backed shoes. Patients also have relief when placing a heel lift in the shoe. This decreases some of the tautness and strain of the achilles tendon overlying the bony spur and can reduce symptoms. Besides wearing open backed shoes, and using a heel lift, other conservative measures include rest, ice, elevation, and reduction of activities. Surgically, the bony spur on the back of the heel can be removed. Depending on how much of the achilles tendon is calcified and how big the spur is, will determine the aggressiveness of the surgery. The most aggressive surgical option includes detaching the achilles tendon from the heel bone or calcaneus, removing the spur on the back of the heel, and removing any calcified parts of the tendon that may be present. The other surgical technique includes doing a "sneak" approach from the side of the heel, without detaching the achilles tendon and removing the spur on the back of the heel only. I prefer exhausting all conservative measures before having surgery, because this surgery can have complications if the patient does not follow strict post-op orders. If all conservative treatement is not helpful, then at that time surgery becomes an option. Surgerical recovery form this type of procedure can be lengthy and it is very important that the patient understands this. The patient will be required to be non weight bearing for at least 6 weeks and may need to be in a walking boot for up to 4 months and in some cases longer. If you have this problem, please come see us and let us help you.

Dr. Kory Williams is a foot and ankle specialist surgically trained to treat all foot and ankle conditions including heel spurs. He practices with Dr. Eric Silvers, also a surgically trained foot and ankle specialist in McKinney, Texas and Prosper, Texas. Their website is www.mckinneyfootcenter.com. Their office phone number is 972-542-2155. Dr. Silvers is now accepting new patients and Dr. Williams will be seeing new patients in July of 2009 at both our McKinney and Prosper Locations.