How to Treat Pain on the Back of the Heel with Seattle Podiatrist Larry Huppin
Hi, we're going to talk about pain in theback of the heel today. So what we're talking about is pain at the very back portion ofthe heel. We're not really talking about the Achilles tendinitis and if we look over hereat this picture here's the Achilles tendon coming in attaching into the back of the heel.If you have pain up in this area, do a search for our page. Go to the website, do a searchfor Achilles tendinitis, and you'll find another tutorial and a lot of information on that. Really what we're talking about now is painright at the back of the heel. So there's a few things that will cause pain in thisarea. Certainly, you can have an inflammation
of the Achilles tendon where it attaches inhere. There's what's called the bursa between the bone and the tendon that acts as a littlebit of cushiony. That can become inflamed, and sometimes this bone will become enlargeditself trapping that tendon between the shoe and the bone. So when we try and treat painat the back of the heel, there's a couple of things we need to do. Number one, certainly we need to get rid ofthe inflammation. So we might use ice, we might use some antiinflammatory medications.We're very resistant to do any sort of injection in that area that can weaken the Achillestendon and that's certainly something you
don't want to do. In addition, we want toget pressure off of this area. So you get pressure off of it by choosing shoes appropriately,doing some stretching on shoes, and sometimes we'll do a little modification of the shoeto get pressure away from this area. Will often use some sort of orthotic device thatwill stop the foot from moving so much. That decreases friction against the back of theheel. So friction it'll play a big role there, andsometimes we'll put special patches that decrease friction on the back of a shoe to stop frictionin this area. Rarely, but sometimes if the bone is enlarged, we do have to go in surgicallyand make that bone somewhat smaller so that
the tendon and the bone is not trapped againstthe shoe. Surgery should always be your very, very last resort. Again, go to our website, do a search forpain on the back of the heel. You'll find information of both conservative and surgicaltreatment for this problem. But again, surgery should be your last resort. If you're in ourarea, make an appointment to see us and we can give you the best conservative treatmentalong with the surgical treatment. If you're not in our area, look for a podiatrist whospecializes in sports medicine and biomechanics.