Summary
- For some people, the back of the heel can rub on shoes causing bony thickening.
- A pump bump can make wearing most shoes extremely painful, predisposing to hyperkeratosis, blistering and inflammation.
- This tends to be on the posterolateral aspect of the heel and is termed a pump bump.
Diagnostic tips
- A prominent bump is both visible and palpable just to the outside upper aspect of the heel which is painful.
- Symptoms are usually exacerbated by rubbing on the heel counter of a shoe or sneaker, and can also be aggravated by an increase in activity.
Tests and Imaging
- Plain x-rays of the ankle, heel, or foot to see pump bumps.
- Axillary heel view (Harris heel view) may show an increased prominence of bone on the lateral aspect of the calcaneus.
- CT or MRI will typically demonstrate some increase prominence of bone and often an associated fluid-filled bursal sac with some swollen soft tissue noted along the back and outside part of the heel bone.
Immediate Treatment
- Symptomatic.
- Advise to avoid shoes that will irritate the inflamed and enlarged area.
Possible Referral
- Podiatry for footwear modification, padding, advice.
- Surgery if nonoperative treatment fails.