If you notice that the boney section of your heel near the Achilles tendon is prominently enlarged, you probably have Haglund’s deformity. Because of the frequent pressure on the back of the heels due to inappropriate footwear or because of the natural shape of the foot, bursitis – an inflammation of the fluid-filled sac between the tendon and the bone – progressively develops.
Haglund’s deformity can happen to anyone. Also known as “pump bump”, the name derives from women that get this condition because of the rigid back of their pumps, though it can also occur in men who wear stiff dress shoes. Inherited foot structure is another cause. If you have a high arch, a tight Archilles tendon or tend to walk on the outer edge of your foot because of its shape, you would be more likely to develop this deformity. Seasoned ice skaters are also at risk because of the long hours practicing in rigid skates.
Symptoms and Diagnosis
Depending on the cause of the problem, Haglund’s deformity may occur in one or both feet. You would notice a bump on the back of the heel, along with severe pain and swelling. Because the soft tissue is inflamed, redness may be visible.
Diagnosis may be difficult because of the similar symptoms to arthritis. However, doing an X-ray to evaluate the structure of the heel could help determine the condition.
Non-surgical and surgical treatment methods are used to relieve the pain and pressure from the heel bone depending on the severity of the deformity. Often, non-surgical treatment is initially tried out to see if the condition improves.
One or more of these methods may be used:
- Icing for 20 minutes every 40 minutes a day to reduce swelling of the inflamed area.
- Stretching exercises to reduce tension of the Achilles tendon.
- Shoe modification using heel pads, heel lifts, arch supports or wearing open-heel shoes to minimize pressure on the heel.
- Using custom orthotic devices to correct the position of the foot.
- Physical therapy like ultrasound treatment and iontophoresis to reduce inflammation
- Immobilization in a cast or brace.
- Taking non-steroidal anti-inflammatory drugs (NSAIDS) to reduce pain and inflammation.
If the pain persists even after the non-surgical treatment, surgery would be necessary. The excess bone of the heel is removed or filed down to relieve pressure on the bursa and soft tissue. After the surgery, the foot is immobilized in a cast for a week, followed by regular visits to the doctor’s to monitor the recovery.