- Osteophyte formation at the insertion of the achilles tendon.
- Generally this occurs with overuse particularly in sport and can take many years to form without being painful.
- Pain directly over the bone at the back of the heel.
- Prominent lump is sometimes present.
- Stretching the Achilles tendon may cause symptoms.
- It may be painful first thing in the morning or on getting up from a chair after a rest.
- Retrocalcaneal bursitis may occur concurrently.
Tests and Imaging
- Clinical examination and a detailed history allow diagnosis.
- X-rays will identify if there is any spur or if the bone is prominent.
- Ultrasound or MRI may identify tendon damage.
- Advise appropriate shoes.
- Acute pain may be relieved by a period of immobilisation in a cam walker.
- Podiatry for footwear advice, padding, and advice on eccentric strengthening program.
- Extracorporeal shockwave therapy has been shown to be effective for this condition.
- Foot and ankle surgeon in severe cases for removal of bone spur.