Posterior Heel Spur


  • 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.

Diagnostic tips

  1. Pain directly over the bone at the back of the heel.
  2. Prominent lump is sometimes present.
  3. Stretching the Achilles tendon may cause symptoms.
  4. It may be painful first thing in the morning or on getting up from a chair after a rest.
  5. Retrocalcaneal bursitis may occur concurrently.

Tests and Imaging

  1. Clinical examination and a detailed history allow diagnosis.
  2. X-rays will identify if there is any spur or if the bone is prominent.
  3. Ultrasound or MRI may identify tendon damage.

Immediate Treatment

  1. Advise appropriate shoes.
  2. Acute pain may be relieved by a period of immobilisation in a cam walker.

Possible Referral

  1. Podiatry for footwear advice, padding, and advice on eccentric strengthening program.
  2. Extracorporeal shockwave therapy has been shown to be effective for this condition.
  3. Foot and ankle surgeon in severe cases for removal of bone spur.