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The response to the question below was authored by Marc Mitnick DPM

Tiny (but painful) bump under heel

by Laban
(Los Angeles)

Hello,

I have a 2-3 mm shallow bump under the heel of my right foot (smack in the middle). It is barely visible, but you by touch you can clearly feel a small bump. It feels like it is something subcutaneous, but I am not a doctor so it is hard to tell. I have seen a DPM and he was not sure, but thought it might be a small hardened "ball of fat" (I do not recall his exact words).

It has been there for ~3 years and the discomfort comes and goes. I know I can use pads with a cut-out, but I would like to find out what it is and hopefully a non-invasive way of getting rid of it.

Any ideas of what this could be and what I can do about it?

Thanks!

Ps. I also have CRPS after tailor's bunion surgery ~3 years ago, which obviously is not helping. It is possible that this little bump has been there all along, but only became painful with the CRPS (mild allodynia in whole foot).

RESPONSE

Hi Laban,

Without the luxury of actually being able to look at it and palpate it, I have no idea what it is. It sounds, from your description at least, that it is in the skin, and not below the skin.
The most common, but not only, cause of a growth in the skin on the bottom of the foot would be a wart, a porokeratosis or plugged sweat gland, a skin cyst and lastly possibly a foreign body.
Basically take your pick.
As, as I see it, it leaves you with a couple of options.
Your podiatrist could anesthetize the area with a little xylocaine and attempt to curette or scoop the growth out and then send it out for a biopsy.
If the problem appears to go deeper then just the skin and the part you can barely see is just the "tip of the iceberg" then you might consider asking your podiatrist to order an ultrasound which might give a better picture of what is going on.
I know you are looking for a non-invasive way to resolve the problem, but scooping the growth out should alleviate your pain and will also allow your doctor to find out exactly what it is. With a small hole in your heel, recuperation should be very quick.

Marc Mitnick DPM
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Nov 19, 2017
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ADDITIONAL REFERENCES

Mayo Clinic

Johns Hopkins Medicine

MedlinePlus

Arthritis Foundation

University of Rochester Medical Center

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Drugs.com

American Academy of Pediatrics

Penn State Medical Center

National Institutes of Health

Columbia University Department of Rehabilitation

ScienceDirect

Stanford Health Care

Illinois Bone and Joint Institute

Mount Sinai Hospital

Institute for Chronic Pain

University of Florida Health

American Family Physician

Cedars-Sinai

University of Maryland Medical Center

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Tiny (but painful) bump under heel

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