A few weeks ago I noticed a swelling at the back of my heel. It is red and tender, and is more painful when I walk, especially in high heels. What could this be?
It sounds like you may have a condition called Achilles Tendon Bursitis. Bursitis means inflammation of the fluid-filled sac (bursa) located at the back of the heel. The Achilles tendon is the tendon that attaches the calf muscles to the heel bone.
The condition is common in young women but can develop in men.
Walking in a way that repeatedly presses the soft tissue behind the heel against the stiff back support of a shoe can cause bursitis.
High-heeled shoes that taper sharply in towards the heel are often the cause. Other conditions such as rheumatoid arthritis, that put extra strain on the Achilles tendon, or a previous injury, can cause a bursitis.
If the condition becomes chronic, the swelling may harden. The pain associated with this particular bursitis is usually felt at and above the heel.
But to confirm the diagnosis you should visit your GP and have it examined. She will probably organise an X-ray of your foot to rule out a fracture of the heel bone or damage caused by arthritis.
If I do have this condition, is there anything that can be done to relieve it?
Treatment is aimed at reducing the inflammation in addition to adjusting the foot's position in the shoe to relieve heel pressure.
Foam or felt heel pads placed in the shoe can help eliminate pressure by lifting the heel. Shoes with padding help reduce irritation to the posterior heel and Achilles tendon. Stretching the back part of your shoes may also help.
You may find that applying cold or warm compresses to the tender area will help temporarily ease the pain and inflammation.
Your doctor may prescribe non-steroidal anti-inflammatory drugs to help relieve your symptoms.
Another treatment option is to inject a mixture of steroid and local anaesthetic into the inflamed bursa with the aim of reducing inflammation and giving pain relief. If these measures do not work then a referral to an orthopaedic surgeon may be necessary with a view to having part of the heel bone removed.
Marion Kerr