Pain and or a lump in my heel
Pain in or around the heel is a common problem and has a wide range of causes. Poor footwear or a sudden change in activities, sporting or otherwise, can precipitate a problem. People mean different things when they use the term 'heel' so the first task is to identify in exactly where the problem is. Sometimes there is a swelling or lump and sometimes not.
The heel includes the ball of the hindfoot where it contacts the ground, the bony section contained within the back part of the shoe and the area above including the Achilles tendon. Pain in the Achilles, especially if there is a knobbly swelling, often means Achilles tendinitis. Some people have a natural prominence of the heel bone (calcaneus) at the rear on the outside edge just where the Achilles tendon attaches. If large, this is called Haglund's deformity. Unfortunately this is where shoes need to grip at the heel and if friction occurs an angry red soft tissue swelling (bursitis) can occur which simply makes the lump bigger and the friction worse. The Achilles tendon itself can begin to develop inflammation where it rubs against this bony prominence.
Pain in the body of the heel bone can be caused by hairline fractures, the result of a period of unaccustomed intensive activity. These stress fractures can also occur elsewhere in the leg or foot. The pain might not develop for a few hours or the day after a long walk or run.
Perhaps new sports shoes were involved or a particularly hard walking/running surface. If the pain is under the ball of the heel where it contacts the ground, or even a little in to the arch, plantar fasciitis is a likely candidate. This usually starts for no obvious reason at all and is particularly painful with the first few steps in the morning. Pinching of the nerve at the side of the heel (tarsal tunnel syndrome) can give a similar pain although there is often a more tingling and widespread nature to the discomfort.
Finally, the heel can sometimes hurt simply because over the years the natural shock absorbing pad of fat beneath the bone has become thin (atrophic fat pad) and is providing insufficient cushioning. Even dry, thick and cracked skin can produce a very painful heel.