Many people visit our office for pain to the back of the heel.  Usually the pain is gradual and there is no trauma that they can remember.  There may even be a bump that they can feel.  Most of the time, this pain is due to inflammation of the achilles tendon and/or a spur on the back of the heel.  This is usually due to having too short of an achilles tendon.  The tendon becomes inflamed where it inserts into the back of the heel bone if it is constantly being strained because it is too short.  Eventually, if the achilles continues to pull on the back of the heel bone, you will develop new bone formation in the direction of the pull which looks like a spur coming from the back of the heel.  Not only is the Achilles tendon inflamed and painful but now the spur is prominent and hurts with pressure.  After a thorough lower extremity physical exam , we will usually take xrays of the affected foot to evaluate for spurring, calcifications within the achilles tendon or any other bony pathology we may suspect.  Treatment begins conservatively and usually starts with  anti inflammatories, aggressive stretching exercises for the short achilles tendon and heel lifts to provide some slack for the tendon.  Other conservative treatment modalities including K-Laser treatment, Physical Therapy, short course of oral steroids and walking boots.  If conservative options fail, surgery may be needed which includes lengthening the achilles tendon and removing the spur from the back of the heel.  At Advanced Foot & Ankle, all of our providers have experience dealing with this issue.  If you suffer from this or any other foot/ankle disorder, please call us at 972-542-2155 for an appointment.