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Foot Conditions

Haglund's Deformity

Haglund’s deformity is a bony enlargement on the back of the heel bone that most often leads to painful bursitis (inflammation of the fluid-filled sac between the tendon and the bone). When the heel becomes inflamed, calcium can build up in the heel bone making the bump larger and increasing your pain. Haglund’s deformity is sometimes referred as “pump bump” because it often occurs in women who wear pumps, and it’s most common in people who wear stiff, closed-heel shoes. Your risk of developing Haglund’s deformity depends on the shape of your heel bone and sometimes patients with a Haglund’s deformity may or may not have pain.

Haglund’s deformity can occur in one or both feet. The symptoms may include:

  • Severe pain in the area where your Achilles tendon attaches to your heel
  • A noticeable bony bump on the back of your heel
  • Swelling in the bursa, which is the fluid-filled sac at the back of your heel
  • Redness near the inflamed tissue

Your doctor will begin by carefully examining your feet. Haglund’s deformity can be difficult to diagnose, due to the symptoms being similar to Achilles tendonitis. Diagnosis of this condition is based on the appearance of your heel.  X-rays may be ordered to get a good look at the structure of your feet. This will help your doctor determine whether you have the prominent heel bone associated with the disease. The X-rays may also help your doctor create orthotics (customized shoe inserts made to stabilize your foot) to relieve your heel pain).

Both surgical and non-surgical treatments are available to relieve the pain associated with Haglund’s deformity.

Non-surgical treatment of Haglund’s deformity is aimed at reducing the inflammation of the bursa. While these approaches can resolve the bursitis, they will not shrink the bony protrusion. Non-surgical options include:

  • Shoe modification - In 50% of cases shoes are the primer cause. Wearing open-back shoes, such as clogs can help with the pain. Your podiatrist may also recommend over-the-counter heel pads, heel lifts, or arch supports, or create custom orthotic supports to change the position of your feet in your shoes to relieve pressure on the back of your foot.
  • Medication - Topical anti-inflammatory medication, applied directly to the heel, may provide pain relief. Oral anti-inflammatory medication such as ibuprofen or aspirin can help as well.
  • Ice - Apply ice over a thin towel to the bump for 20-40 minutes per day to reduce swelling .Do not put ice directly against the skin.
  • Exercises - Stretching exercises help relieve tension from the Achilles tendon.
  • Immobilization - If the area is extremely inflamed, a custom-made soft cast or walking boot may be used to immobilize the area and allow it to heal.
  • Physical therapy - Inflammation is sometimes reduced with certain forms of physical therapy, such as ultrasound therapy.

Surgical Treatment
If none of the non-surgical methods provide adequate relief, your podiatrist may recommend surgery to correct the deformity. The surgery should be performed on an out-patient basis with the use of either a local or general anesthesia. During surgery, your doctor will remove the excess bone from your heel. The bone may also be smoothed and filed down.

After surgery, it will take up to 8 weeks for you to completely heal. A boot or a cast will be applied to protect your foot. You may also need to use crutches for a few days. After two weeks, stitches will be removed and X-rays of your foot will be taken on your follow-up visits to ensure that it’s healing properly