This is an inflammation of the tendon at the back of the heel. This causes pain and thickening of the tendon and often a bump is palpable at the back of the heel. Activity modifications, orthotic prescriptions, ice, calf stretching exercises, heal lifts and anti-inflammatory medications help relieve the symptoms in majority of cases. In refractory cases MRI is used to assess the condition of the tendon. Surgical treatment involves removal of the degenerated and painful tendon and bony bump at the back of the heel along with tendon lengthening or reconstruction with an adjacent tendon of the big toe. The heel is initially put in a plaster cast in foot down position and the heel is gradually brought down to the floor over a period of 6 weeks.