The first possible explanation for the painful lump under the heel is a condition known as the Haglund deformity. Also known as a “pump bump”, this is an abnormal, bony protrusion on the bottom of the heel. It develops in response to persistent pressure applied to the area over a long period of time.
The Haglund deformity is a fairly common condition, affecting approximately 0.04% of the adult population worldwide. A more severe and fatal variant of the Haglund deformity occurs when a heel is compressed so severely during vigorous exercise that the lump forms on the bottom of the heel, producing a hard bump. In extreme cases, this type of deformity is fatal.
The second possible explanation is a problem with the heel itself. The heel has an incredibly small surface area. A lot of pressure must be applied to the area of the heel to affect significant deformity.
When the pressure is intense enough, the heel will actually buckle inwards (due to internal friction) and the pressure on the area will force the heel to develop a lump under the heel (known as the Haglund deformity). These cases are caused by a defect in the heel’s structure or a flaw in the heel’s bone structure that allow the heel to swell and the lump to form.
Lump Under Baby’s Heel
There are very few cases of an infant developing a lump under the heel (haglund deformity). The cause of this is unknown, but a more likely cause is a problem with the bone structure of the heel itself.
How can I determine if the lump in my heel is actually a problem?
If you are unsure about if a lump under your heel is actually a problem, or if it’s an indication that a problem exists, talk to your physician. A doctor can help you determine if there is a problem, or if there is nothing wrong with your heel.
What is the diagnosis of a heel lump under the heel?
Doctors can use a variety of diagnostic tests to confirm that you are not experiencing a Haglund deformity. This might include your blood test for B-Vitamins, X-rays for a possible problem with the heel bone structure, X-rays for a possible problem with the heel bone structure, a CT scan of the heel, and other tests that can reveal a problem in the heel.
What are the symptoms of a heel lump under the heel?
Usually, the first symptom that occurs is the bump under your heel. If this first symptom is not present, the lump is likely to not be related to your heel’s structure or to a bone condition in your heel. Sometimes a bump under the heel will develop into an actual lump, so your doctor will first order a CT scan to determine if there is a problem with the heel bone structure or if the lump is simply an anomaly.
You will also be asked to walk around your heel (in a straight line) in a straight line for a period of time (e.g. 3 minutes, 5 minutes, 10 minutes, etc). This allows the doctor to evaluate the lump under the heel, examine the heel, and take measurements.
The doctor can take any of these measurements, including your heel length, the width of your heel under the heel, the distance between the heel and your heel when you lie down, and if there is a lump or not. If there is a lump, the doctor will recommend treatment, which might involve:
Treatment for Painful Lump Under the Heel
Your doctor can perform a heel lump under the heel exam to determine the cause of the lump and to make any necessary treatment decisions.
- Injection of a local anesthetic or a steroid
- Surgery to insert an appliance to pull the lump out of the heel
Painkillers for pain and swelling, such as ibuprofen, naproxen sodium, or acetaminophen,
Treatment for the lump might include:
- Using special surgery to remove and replace bone that has been lost (known as a “plasty”)
- Surgical reshaping of your heel to take your heel back into its correct shape
- Preventative medicine such as antibiotics and anti-inflammatories
- Corticosteroids for pain and swelling, such as prednisone or aspirin
- Prescription medications such as calcium or magnesium supplements to replace lost calcium and magnesium,
- Prophylactic antibiotics to protect against a possible future infection
- Surgical removal of the lump and replacement of the missing bone
How can I avoid a heel lump under the heel?
While the lump under the heel can be annoying, if it is causing you pain, stop exercising as soon as possible. Also, continue to take painkillers as needed. You may be able to avoid the lump by wearing a flat-soledges that are designed to protect the heels from external pressure. A flat-soledges may help, but do not protect the whole heel from external pressure. If you cannot wear a-sol shoes to prevent the heel, try wearing an elastic sandals under shoes and sandals.
