Pain at the Back of Your Heel? Causes and Treatment Options
If you're experiencing pain at the back of the heel, you're not alone. This is one of the most common complaints we see at Lower Limb Clinic, and it's often a sign of Insertional Achilles Tendinopathy or Haglund's Deformity. The good news? With proper diagnosis and treatment, most patients experience significant improvement within 8-12 weeks with appropriate treatment.
Common Causes of Pain at the Back of the Heel
Insertional Achilles Tendinopathy
The Achilles tendon inserts at the back of the heel bone. Degeneration at this attachment point causes localised pain, often with a visible bump.
Who typically experiences this: Middle-aged adults, those who wear low-backed shoes, runners.
Haglund's Deformity
A bony enlargement at the back of the heel (pump bump) causes irritation and pain, especially with enclosed shoes.
Who typically experiences this: Women who wear heels, those with high arches, people with rigid shoes.
Retrocalcaneal Bursitis
Inflammation of the bursa between the Achilles tendon and heel bone causes pain at the back of the heel.
Who typically experiences this: Runners, those with Achilles problems, people with tight calves.
Without proper assessment, it's impossible to know exactly what's causing your pain at the back of the heel. What works for Insertional Achilles Tendinopathy may not help—or could worsen—Haglund's Deformity.
When Should You Seek Professional Help?
You should book an assessment if:
- Pain at the back of your heel has lasted more than 2 weeks
- You notice a bump or swelling
- Pain affects your walking or running
- Certain shoes make it worse
"Most patients we see have tried various home remedies before booking. You're not wasting our time—persistent symptoms warrant professional assessment."
Our Diagnostic Approach
At your initial consultation, we'll:
Take a detailed history
Understanding when your pain at the back of the heel started, what makes it better or worse, and your activity levels.
Physical examination
Hands-on assessment of your foot, ankle, and lower limb.
Biomechanical assessment
Evaluating how you stand and walk, identifying any contributing factors.
Gait analysis (if indicated)
Video and pressure plate analysis to understand your movement patterns.
We'll explain our findings clearly and discuss all treatment options before recommending a plan.
How We Treat Pain at the Back of the Heel
Depending on your diagnosis, treatment may include:
Ultrasound assessment
Visualise the tendon, bursa, and bone
Heel lifts and orthotic modification
Reduce tension on the Achilles insertion
Eccentric exercises
Specific loading programme for tendon healing
Shockwave therapy
Effective for insertional Achilles problems
"We don't believe in one-size-fits-all treatment. Your plan will be tailored to your specific diagnosis, lifestyle, and goals."
"I'd been suffering with pain at the back of the heel for months before finally coming to Lower Limb Clinic. Within weeks of starting treatment, the improvement was remarkable. Wish I'd come sooner!"
— Verified Patient Review
Common Questions About Pain at the Back of the Heel
Ready to Find Out What's Causing Your Pain at the Back of the Heel?
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