What is Haglund Deformity?
Haglund Deformity is a pathological condition of the musculoskeletal system in which an individual develops a bump on the back of the heel. This bump is mostly seen in people who wear stiff and closed soled shoes. Haglund Deformity is basically an abnormality of the bones and soft tissues of the foot.
Haglund Deformity is triggered by enlargement of a bony section of the heel resulting in a noticeable bump. This bump then starts to get irritated when it rubs against any type of rigid shoes resulting in a medical condition termed as bursitis. Bursitis is a medical condition in which there is inflammation of the bursal sac between the tendon and bone of the heels. When this happens, there is a buildup of calcium in the heel bone which further increases the bump and makes the Haglund's Deformity more prominent and also is a cause for increased pain in the back of the heel.
Haglund Deformity can be treated both conservatively as well as surgically depending on the severity of the deformity and the symptoms that is experienced by the patient.
What are the Causes of Haglund Deformity?
The main cause for development of Haglund Deformity is excess pressure on the back of the heels. This increased pressure may be caused due to wearing tight shoes which are very stiff at the heel. Majority of cases of Haglund Deformity is seen in women who wear pump style high heels. People who have high arches are also at risk for developing Haglund Deformity. People with a tight Achilles tendon are also predisposed to having Haglund Deformity.
What are the Symptoms of Haglund Deformity?
Some of the symptoms of Haglund Deformity are:
- A visible bony bump at the back part of the heel
- Severe pain at the attachment site of the Achilles tendon to the heel
- Bursal swelling
- Erythema near the inflamed tissues.
How is Haglund Deformity Diagnosed?
Haglund Deformity is a tough condition to diagnose as its symptoms are quite similar to that of Achilles tendonitis and other foot problems. Hence it is imperative for a doctor to perform a close examination of the heel and observe the appearance of the heel in order to come to a conclusion of whether it is indeed Haglund's Deformity.
If Haglund Deformity is suspected, then the doctor will order radiological studies in the form of x-rays of the heel bone to see if there is any prominence of the heel bone which is a telltale sign of Haglund Deformity. The x-ray will also help the doctor to assess the extent of the condition and to formulate an accurate treatment plan for the patient in the form of fabricating orthotics which would be best suited for the patient's condition.
How is Haglund Deformity Treated?
Haglund Deformity can be treated both conservatively and surgically. The main aim of treating Haglund Deformity is to relieve pressure off of the heel bone and calming down the pain. Some of the conservative options available for treatment of Haglund Deformity are:
- Wearing open-back shoes
- Use of NSAIDs like ibuprofen or Tylenol for pain relief and calming down inflammation associated with Haglund Deformity.
- Icing the bump for 15-20 minutes two to three times a day to help calm down the swelling, pain, and inflammation
- Soft tissue massages for the heel bone for pain relief
- Fabrication of orthotics so as to reduce pressure off of the heel bone while wearing shoes
- Wearing heel pads to cut down the pressure from the shoes
- Casting is yet another conservative treatment for Haglund Deformity.
Surgery is often recommended for treatment of Haglund Deformity if other nonsurgical approaches fail to relieve symptoms. The surgery for Haglund Deformity involves removal of the excess bone from the heel and thus eliminating the bump. Also, the bone may be smoothened down. This helps in reducing the pressure on the bursa and soft tissues. The surgery is done under general anesthesia, especially if the patient has a damaged Achilles tendon and that also needs fixation. Postsurgery, it usually takes about 8-10 weeks for the patient to complete recover and go back to normal activities. During this time, the foot may be placed in a cast or a boot for protective purposes. The patient may also have to use crutches for a few days postsurgery for Haglund Deformity. Regular followups will be scheduled along with serial x-rays to look at the status of the foot and whether it is healing at an appropriate rate or not after surgery for Haglund Deformity.
What is the Prognosis of Haglund Deformity?
The prognosis for Haglund Deformity is quite good with treatment. As stated above, after surgery it usually takes about 10 weeks before the patient can return back to normal activities. In some cases, the patients may have recurrence of symptoms but if necessary precautions are taken like wearing open shoes and taking care of the feet such that no excess pressure is put on the heel then the patient should do quite well after having been treated for Haglund Deformity.