Pain on the back of the heel if often caused by an overgrowth of bone on the back of the heel bone (calcaneus). This is called a retrocalcaneal exostosis. Retrocalcaneal exostosis problems are often related to chronic tugging of a tight Achilles tendon on the back of the heel. With time, there is the development of spurs on the back of the heel which cause pain with shoe and destroy the attachment of the Achilles tendon. Often, there is both extra bone formed and Achilles tendinosis or scar tissue in the Achilles tendon. For conservative care, care, physical therapy and orthotics may be used. If surgery is necessary, removal of scar tissue with the Topaz procedure may be used to removed the scar tissue and increase blood supply to the tendon. If spur removal is necessary, the procedure may be done arthroscopically to limited the incision and trauma to the area or may need to be done through an open incision is severe cases. The key to a good outcome is a solid reattachment of the Achilles and complete removal of scar tissue and bone spurs. The Foot and Ankle Institute doctors have extensive knowledge in the conservative and surgical care of Achilles tendinosis and spur removal related to retrocalcaneal exostosis. We offer a full level of care including physical therapy, bracing and surgical options.

Picture showing prominent bone over the back of the heel bone (calcaneus) from a side view.	Picture showing prominent bone over the back of the heel bone (calcaneus) from a back view.
X-Ray showing extra bone formation over the heel bone.
X-Ray showing extra bone formation over the heel bone.

Picture showing a small growth of bone over the heel bone.	Picture during surgery showing the Achilles tendon opened to show the extra bone over the heel bone.
Picture during surgery showing the extra heel bone removed..	Picture during surgery showing the achilles tendon repaired over the bone..