Pump Bump

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

  1. A prominent bump is both visible and palpable just to the outside upper aspect of the heel which is painful.
  2. 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

  1. Plain x-rays of the ankle, heel, or foot to see pump bumps.
  2. Axillary heel view (Harris heel view) may show an increased prominence of bone on the lateral aspect of the calcaneus.
  3. 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

  1. Symptomatic.
  2. Advise to avoid shoes that will irritate the inflamed and enlarged area.

Possible Referral

  1. Podiatry for footwear modification, padding, advice.
  2. Surgery if nonoperative treatment fails.

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