December 9, 2020: Do you have small bumps around your heels?
Do you have small bumps around your heels?
Many people are concerned that they have small lumps around the circumference of their heels.
Although they can appear alarming they are known as piezogenic papules are quite harmless and in the main, painless.
They comprise soft, compressible lumps, often on the back and round the side of the heel and commonly on both feet.
A determining feature is that they vanish when the foot is off the ground.
What causes them?
The cause is small herniations in the fatty tissue of the heel(s) breaking through tiny tears in the fascia (retaining connective tissue) of the heel under load, which is why they are invisible when the foot is lifted from the floor.
Piezogenic papules are more likely in the young and athletic and tend to occur more commonly in females than males.
People who have the connective tissue disorder, Ehlers-Danlos syndrome (EDS) are more susceptible, as are those who stand for long periods of time such as shop workers and hairdressers.
Athletes such as long distance runners may well develop piezogenic papules.
Why do some people get them and not others?
They are not age or race specific.
Weight is sometimes a causative factor.
Ranging from 2 mm to 2 cm in size, they are usually pain free.
Occasionally they can be painful if nerves herniate through the fascia together with the fatty tissue.
Painful papules are usually larger than 2cm, are less frequent and usually linked to a history of long periods of standing.
What can I do?
Painful piezogenic papules require some change in lifestyle, reducing weight bearing exercise and where appropriate, reduction of body weight.
Compression stockings can assist by preventing the herniations in the first place, while heel cups or taping may help relieve pain.
A visit to your Podiatrist will guide you towards a tailored solution, from exercise to orthotics.
When the papules are painless benign neglect is the best policy.
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