A lump on the side of your heel is any abnormal protrusion or swelling in that area. While many heel lumps are benign and often resolve with conservative care, some may indicate underlying conditions that require medical attention. This article provides general information about common causes and related symptoms of heel lumps. Always consult a healthcare provider for an accurate diagnosis and appropriate treatment plan.
Understanding Common Heel Lumps
Several conditions can lead to a lump on the side of the heel, each with distinct characteristics.
Haglund’s deformity, often called “pump bump,” is a bony enlargement on the back of the heel bone (calcaneus) where the Achilles tendon attaches. This bump can become irritated by shoe pressure, leading to pain, swelling, and redness.
Retrocalcaneal bursitis is inflammation of a fluid-filled sac (bursa) located between the Achilles tendon and the heel bone. This bursa normally provides cushioning, but overuse, repetitive movements, or irritation can cause it to swell and form a noticeable lump. Symptoms often include pain, tenderness, and warmth.
Insertional Achilles tendinopathy involves inflammation or degeneration where the Achilles tendon connects to the heel bone. This can manifest as a thickening or lump at the tendon’s insertion point, often accompanied by pain during activity or when pressure is applied. Overuse, tight calf muscles, or improper footwear can contribute to this condition.
Ganglion cysts are non-cancerous, fluid-filled sacs that can develop near joints or tendons. These cysts contain a jelly-like fluid and can vary in size, sometimes appearing as a soft or firm lump. While the exact cause is often unknown, they may arise from trauma.
Bone spurs, also known as osteophytes, are bony growths that can form on the heel bone, often at the attachment points of tendons or ligaments. While not always painful, they can irritate surrounding soft tissues, potentially leading to a noticeable lump and discomfort. These spurs result from chronic stress.
Fat pad atrophy refers to the thinning or displacement of the protective fatty tissue cushioning the heel. This condition can make underlying bone structures feel more prominent, mimicking a lump, and often causes pain, especially when walking barefoot or on hard surfaces. Age, obesity, and repetitive high-impact activities can contribute to its development.
Less common causes include lipomas, which are benign fatty tumors, and fibromas, which are benign fibrous growths. Lipomas are soft, rubbery masses of fat cells under the skin. Fibromas are fibrous knots that can occur in the arch of the foot and may cause pain with pressure.
Recognizing Accompanying Symptoms and Red Flags
A lump on the side of your heel can present with various accompanying symptoms that help indicate the underlying cause. Common symptoms include pain, which can range from a dull ache to sharp sensations, often worsening with activity or pressure from footwear. Tenderness, swelling, redness, and warmth around the lump are also frequently observed, suggesting inflammation. Stiffness in the ankle, difficulty walking, or discomfort when wearing certain shoes are additional signs. Changes in the skin’s appearance over the lump, such as calluses, bruising, or blistering, can also occur due to friction.
Certain accompanying symptoms act as “red flags” and warrant prompt medical evaluation. These include:
Sudden onset of severe pain or swelling.
Inability to bear weight on the affected foot.
Signs of infection, such as fever, chills, spreading redness, or pus.
Numbness or tingling in the foot, suggesting possible nerve involvement.
A lump that rapidly increases in size, changes shape, or feels hard, fixed, or irregular.
Persistent pain that does not improve with rest or home care.
Medical Evaluation and Management
When seeking medical attention for a heel lump, a healthcare provider will typically begin with a comprehensive diagnostic process. This includes a thorough review of your medical history and a physical examination of your foot. During the exam, the doctor will palpate the lump to assess its size, consistency, and tenderness, and may also check your foot’s range of motion.
Imaging tests are often utilized to gain a clearer understanding of the lump’s nature. X-rays can help identify bony abnormalities like bone spurs or Haglund’s deformity. For soft tissue issues such as bursitis or cysts, an ultrasound may be performed. In cases requiring more detailed assessment of soft tissues or complex conditions, a magnetic resonance imaging (MRI) scan might be recommended.
Treatment approaches for heel lumps generally fall into conservative management, injections, or, in some instances, surgical options. Conservative management is typically the first line of treatment. This often involves rest, applying ice to reduce swelling, compression, and elevating the foot. Over-the-counter anti-inflammatory medications can help manage pain and inflammation. Shoe modifications, such as wearing open-backed shoes, using heel pads, or incorporating custom orthotics, can reduce pressure and provide support. Physical therapy, including stretching and strengthening exercises, is also a common component of conservative care to improve foot mechanics and reduce irritation.
If conservative measures are not effective, injections may be considered. Corticosteroid injections can help reduce inflammation in conditions like bursitis or tendinopathy, while aspiration can drain fluid from certain cysts. Surgery is usually reserved as a last resort for persistent cases that do not respond to other treatments. Surgical procedures might involve removing bone spurs, excising inflamed bursae, or repairing damaged tendons.
Strategies for Prevention
Preventing heel lumps, or managing existing conditions to avoid recurrence, often involves proper foot care and activity modification. Selecting appropriate footwear is a primary preventative measure. It is important to wear shoes that fit well, provide adequate arch support, and offer sufficient cushioning to absorb impact. Avoiding shoes with rigid backs that can rub or put excessive pressure on the heel helps prevent irritation that can lead to conditions like Haglund’s deformity or bursitis. When introducing new shoes, it is beneficial to break them in gradually.
Gradually increasing activity levels is another strategy to prevent heel issues. Sudden increases in the intensity or duration of exercises, especially those that stress the heel, can contribute to inflammation and lump formation. Instead, incremental progression allows the foot and ankle structures to adapt. Regular stretching of the Achilles tendon and calf muscles, along with strengthening exercises for foot and ankle stability, can improve flexibility and support, reducing strain on the heel.
Maintaining a healthy weight can also reduce stress on the heels, as excess body weight places additional load on the feet. For individuals with specific foot biomechanics that predispose them to heel problems, consulting a podiatrist for gait analysis or custom orthotics can help correct imbalances and distribute pressure more evenly across the foot.