Feet develop problems at both ends, and it's not unusual to deal with more than one at the same time. A hard bump rubbing at the back of your shoe is a different condition to a toe that's curled and won't straighten, but both are common, both get worse with the wrong footwear, and both have a clear treatment pathway once properly assessed. This guide covers effective heel bumps treatment, plus what's usually involved in treatment for hammer toe that's become fixed and painful.

Clinical detail on heel bumps comes from Mr Pavel Akimau, Consultant Orthopaedic Surgeon at University Hospitals of North Staffordshire NHS Trust since 2021, who is the sole surgeon in the region performing the minimally invasive correction described below on a regular basis.

Two conditions at a glance

What causes a heel bump, and how heel bumps treatment usually starts

A heel bump, medically known as Haglund's deformity, develops where the Achilles tendon connects to the heel bone, the calcaneum. It shows up as a painful bony lump at the back of the heel, and it makes wearing ordinary shoes truly uncomfortable, since the rigid back of most shoes rubs directly against the lump with every step.

Friction, pressure and inflammation from ill-fitting shoes are the common triggers, and the discomfort tends to build gradually, not appear overnight. Sensible heel bumps treatment starts with the basics: softer-backed shoes, cushioning pads, and rest from whatever activity is aggravating it. Some patients respond well to a targeted shockwave therapy injection at this stage, which can settle things without needing to go any further.

When heel bumps treatment means surgery

More often than not, though, surgery becomes the option that actually resolves things, instead of just managing the symptoms. The established approach is MIS Zadek's osteotomy, a minimally invasive procedure that shortens the heel bone through tiny skin incisions, relieving the pressure between the diseased tendon and the diseased bone beneath it.

It has a very high success rate, and Mr Akimau is the sole surgeon in the region performing this technique regularly. Patients are able to walk immediately afterward in a special boot, worn for about four weeks, with pain typically continuing to improve over the following weeks as healing settles in.

What a hammer toe is, and why the fix depends on flexibility

A hammer toe is a toe, usually one of the smaller ones, that bends downward at the middle joint instead of lying flat. Tight shoes, a tendon imbalance, or pressure from a neighbouring bunion are all common contributors, and the deformity tends to worsen gradually if the underlying cause isn't addressed.

The single most useful thing to establish, before deciding on treatment for hammer toe, is whether the toe is still flexible or has become rigid. A flexible toe can still be straightened by hand, and it usually responds well to wider shoes, toe spacers and padding, without needing surgery. A rigid toe, one that's stuck bent even with gentle pressure, generally needs a surgical procedure to correct it properly, since exercises and spacers alone won't reshape a joint that's locked in position.

Getting treatment for a hammer toe right from the start

Because the flexible-versus-rigid distinction changes the entire treatment plan, it's worth having a hands-on assessment instead of guessing from home. Effective treatment for a hammer toe also means checking for a contributing bunion or tight tendon nearby, since treating the toe in isolation while ignoring the underlying cause tends to bring the problem back. [CONFIRM: Mr Akimau's specific surgical technique and recovery timeline for hammer toe correction, since current published detail on this site focuses on heel bumps, not lesser toe deformities specifically].

Simple daily habits that help both conditions

• Choose shoes with a soft heel back and a roomy toe box

• Avoid narrow, pointed styles for anything beyond short periods

• Introduce toe spacers or padding early, not after pain sets in

• Don't ignore a bump or a curled toe that's steadily getting worse

Frequently asked questions

Can a heel bump go away without surgery?
Softer footwear, padding and shockwave therapy resolve many cases without surgery. Surgery becomes the more common route only when those measures haven't settled things.

How long does recovery take after heel bump surgery?
With MIS Zadek's osteotomy, patients typically walk immediately in a special boot worn for about four weeks, with pain continuing to ease over the following weeks.

Is treatment for hammer toe always surgical?
No. A flexible hammer toe often responds to wider shoes, spacers and padding. Surgery is generally reserved for a toe that's become rigid.

Can heel bumps and hammer toes be treated at the same appointment?
They're assessed and treated as separate conditions, though there's no reason both can't be discussed and planned for in the same consultation.

Who is the right specialist to see for these conditions?
A Consultant Orthopaedic Surgeon specialising in foot and ankle conditions, ideally one who performs the specific minimally invasive techniques described above on a regular basis.

Get in touch

Mr Pavel Akimau is a Consultant Orthopaedic Surgeon based in Staffordshire, seeing patients in Staffordshire, Cheltenham and Bristol. Call 07934 539252 or 01782 432227, email help@pavelakimau.com, or visit the Heel Bumps page to book an appointment.