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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 31327
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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I have been having ankle pain in the back above the heel (behind

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I have been having ankle pain in the back above the heel (behind the maleoli) for over a week. For the first few days it was severe at night, keeping me awake. For the past 2 days I have had the same pain during the day upon dorsiflexion and plantar flexion. Tonight the pain is also around the medial maleolus and I have the sensation that it is swollen although it doesn't appear so. Any thoughts??

Hello Amy,
I am Dr. Arun and will be helping you today.

Gout is one of the possibilities of the diagnosis. This is due to increased serum (blood) uric acid. Colchicine is the medication taken for the acute attack of gout. A family history is many times associated. If you had any unaccustomed activity in last 3-5 days, muscle strain or ligament strain are the other reasons for these symptoms. The other possibilities of the diagnosis are;

1) Achilles tendinitis; heel tendon inflammation


2) Retrocalcaneal bursitis; bursa are fluid filled sac (pocket like structures) for smooth movement of the tendon, which can get inflamed and termed bursitis. The heel bone is called calcaneum and the bursa below it is inflamed thus the term retrocalcaneal.


3) Plantar fasciitis; heel has got a soft tissue underneath called as plantar fascia, inflammation of which is called plantar fasciitis.


4) Calcaneal periostitis; heel bone inflammation


5) Calcaneal spurs; wear and tear arthritis forms small bone growth.

An MRI and x-ray can confirm the diagnosis with the blood work.

The treatment is almost same for all these conditions with the minor variations. Following may help you;


1) Moist heat or ice compresses; whatever suits you

2) Anti-inflammatory analgesics like Ibuprofen

3) Local analgesic ointment /spray

4) Physical therapy

5) Deep electrotherapy like iontophoresis, phonophoresis, short wave diathermy, electrical stimulation etc.

6) Consideration of steroid shot

7) Shock wave therapy

8) Custom-fabricated inserts in shoe-wear

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Thanks for using Just Answer.


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Customer: replied 3 years ago.
Other than imaging, is there any way to narrow down the possibilities? Would you suggest that I see my primary care physician, an orthopedist, or a podiatrist for diagnosis? Thank you.

You are very welcome, Amy.

Your can consult your primary care physician initially. A physical examination is most of the time good enough to diagnose the condition. Occasionally a blood work for the gout would be suggested if there is a suspicion of the gout (redness, swelling, tenderness with the family history or previous attack of gout). Tendonitis, bursitis can be substantiated clinically.

It is privilege assisting you.

Dr. Arun


Just wanted to add; a shoe wear many times can be related. A new pair of shoes, high heels with prolonged standing or walking can be associated with these symptoms.

Please let me know if you have any further queries. A positive rating (if you are completely satisfied) would be appreciated as that only gives credit and compensate us for work. You can ask follow up questions, even after rating.

Thank you.

Best wishes and kindest regards.

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