Causes and risk factors
The exact cause of enlargement of the bone is not known. Certain genetic factors seem to be responsible for this. Inherited structure of the foot makes the foot more vulnerable for development of bony protuberance. Typical walking pattern of walking on outside edges of the heel or people suffering from tight Achilles tendon, and high arches of foot favor extra growth of the bone. High heeled shoes with rigid back, women pump shoes are the triggering factors or can aggravate the condition.
Clinical presentation:
Extra bony growth resulting in bony protuberance at the back of the heel is the prominent feature of this condition. The complaint can be unilateral or bilateral. Dull aching pain is felt at the heel. Rubbing of the bone causes irritation of the bursa leading to its inflammation. This causes swelling at the heel. The overlying skin becomes red and on examination the bony growth can be felt and tenderness is present.
Investigations:
Diagnosis is done on the basis of the symptoms narrated by the patient and a local examination is carried out by the orthopedic doctor. An x-ray of the affected foot is usually sufficient for diagnosis.
Treatment:
The treatment plan depends upon the severity of affection. The treatment consists of administration of medications like pain reliving medication and nonsteroidal anti-inflammatory drugs. Ice pack application is recommended for relieving the swelling. Modification of shoes is must. Shoes having cushions on heel or soft backed shoes, backless shoes, or use of heel lifts in high arched people is advised. In a few cases, cast application is done for immobilization. In severe cases, surgical intervention is needed. Removal or trimming of the extra bony growth is done.
Other Modes of treatment:
Certain yoga exercises or physical exercises under a trained physiotherapist will help to strengthen the muscles and improve the flexibility.
When to contact a doctor:
Seek an advice from an orthopedic doctor if one experiences any pain, discomfort, or swelling at the heel.
Prevention:
One must avoid running on hard surfaces or up the hill. Wear appropriate sized and shaped shoes. Avoid prolonged wearing of high heel or rigid heel shoes.
System Involved: Musculoskeletal system
Organ involved: Muscles, bone, nerves, heel, bursa, and ligament
