Sometimes the smallest physical conditions can cause major distraction and pain. This is true with many foot disorders, including Haglund’s deformity. While its name might not sound familiar, its symptoms might be—a bony bump on the back of the heel that is irritated by shoe friction, causing pain and discomfort. Treating Haglund's deformity without surgery

Understanding Haglund’s Deformity

Haglund’s deformity develops where your Achilles tendon attaches to your heel. The soft tissue immediately surrounding this tendon becomes irritated when the bony enlargement rubs against shoes and other surfaces. This leads to bursitis, which is an inflammation of the bursa—a fluid-filled sac between the bone and tendon.

Haglund’s deformity is fairly common but not well understood. Podiatrists suspect it’s most common among middle aged women and usually appears on both feet instead of just one. When you see a doctor to determine the cause of your pain, Haglund’s deformity is often misdiagnosed as:

  • Plantar fasciitis
  • Achilles tendon calcific enthesopathy
  • Retrocalcaneal bursitis
  • Seronegative spondyloarthropathies

Even when properly diagnosed, the symptoms and treatment options for Haglund’s deformity can definitely be frustrating.

Causes of Haglund’s Deformity

There are different causes of Haglund’s deformity, but it is often called “pump bump” due to the amount of cases caused simply by the rigid backs of high heels and other types of shoes that lack flexibility. This creates pressure that continues to aggravate the deformity whenever the individual walks. Some types of shoes that are the main culprit of Haglund’s deformity include:

  • Women’s pumps/high heels
  • Men’s dress shoes
  • Ice skates or roller skates
  • Work boots
  • Any other shoe that is too tight and/or ill-fitting

Haglund’s deformity can also be caused by:

  • Genetics 
  • High arches
  • Walking regularly on the outside of your feet
  • Overtraining for certain sports, particularly running
  • Abnormal foot biomechanics due to joint misalignment, including from an injury

Can Haglund’s Deformity Be Cured Without Surgery?

Surgery can be a scary thought for many people, and those who suffer with Haglund’s deformity wonder if their condition can be treated without it. But this condition requires surgery to completely remove the bumps. However, there are more conservative treatments that can reduce the size of the bumps and ease symptoms, which is an option some choose instead.

Surgery

If you choose to have surgery on your Haglund’s deformity, the procedure is usually outpatient, which means you won’t have to stay in the hospital overnight. Your surgeon will either use general anesthesia or a nerve block to numb the leg that will be operated on. An incision is then made at the heel next to the Achilles tendon. Once the incision is made, the doctor will remove the protruding bone. If any portion of the Achilles tendon has become degenerative due to the progression of Haglund’s deformity, they will remove that as well. In some instances, another tendon will be transferred to replace the portion of the Achilles that is unable to be repaired.

If you have a straightforward surgery where the deformity is easily removed without impacting the surrounding region, you can expect to recover in about two weeks. Once your sutures are removed, you can begin to bear weight again on the affected foot. However, if your surgery involves any sort of tendon repair, recovery will be longer. You will likely receive a medical boot with a heel lift and will also be encouraged to participate in physical therapy.

Alternative Treatments

Although surgery is the only way to truly remove Haglund’s deformity, some people choose other options because of co-existing conditions that make anesthesia risky. Others may fear potential complications. Rare but significant complications from Haglund’s deformity removal include the wound healing too slowly, which can cause infection or require another surgery.

While surgery might be the only true resolution, there are treatments focused on pain and size reduction that make it possible to live comfortably with Haglund’s deformity. These include:

  • Anti-inflammatory medications
  • Regularly icing the inflamed area
  • Stretching exercises to reduce tension from the Achilles tendon
  • Heel lifts—ideal for patients with high foot arches to decrease pressure on the heel
  • Heel pads—to provide cushioned support and reduce irritation when walking
  • More flexible shoes
  • Physical therapy
  • Orthotic devices

Are You Looking for Expert Foot Care in Austin, TX?

If you are looking for expert foot care, you should reach out to an experienced podiatristAustin Foot and Ankle Specialists can help. Our office provides a wide variety of advanced, effective treatment options for all kinds of painful conditions. Ready to schedule an appointment? Contact us online our Austin office at 512.328.8900.

 

Craig Thomajan
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Austin Podiatrist