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Haglund’s deformity is an abnormality of the foot bone and soft tissues. An enlargement of the bony section of your heel (where the Achilles tendon is located) triggers this condition. The soft tissue near the back of the heel can become irritated when the large, bony lump rubs against rigid shoes. This often leads to bursitis.
Bursitis is an 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. This makes the bump larger and increases your pain.
Haglund’s deformity can develop in anyone. However, it’s most common in people who wear stiff, closed-heel shoes.
Haglund’s deformity occurs when there’s frequent pressure on the backs of your heels. It may be caused by wearing shoes that are too tight or stiff in the heel. Since it often develops in women who wear pump-style high heels, Haglund’s deformity is sometimes referred to as “pump bump.”
You may also be more at risk for getting Haglund’s deformity if you have a high foot arch, have a tight Achilles tendon, or tend to walk on the outside of your heel.
Haglund’s deformity can occur in one or both feet. The symptoms may include:
- a bony bump on the back of your heel
- severe pain in the area where your Achilles tendon attaches to your heel
- swelling in the bursa, which is the fluid-filled sac at the back of your heel
- redness near the inflamed tissue
Haglund’s deformity can be difficult to diagnose because the symptoms are similar to those associated with other foot issues, including Achilles tendonitis.
Your doctor might be able to diagnose the condition based on the appearance of your heel. Your doctor may request an X-ray of your heel bone if they think you have Haglund’s deformity. This will help your doctor determine whether you have the prominent heel bone associated with the disease.
An X-ray may also help your doctor create orthotics to relieve your heel pain. Orthotics are customized shoe inserts made to stabilize your foot.
The treatment for Haglund’s deformity usually focuses on relieving pain and taking pressure off of your heel bone. Nonsurgical options include:
- wearing open-back shoes, such as clogs
- taking nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin IB) or aspirin (Bufferin)
- icing the bump for 20 to 40 minutes per day to reduce swelling
- getting ultrasound treatments
- getting a soft tissue massage
- wearing orthotics
- wearing heel pads to reduce pressure from your shoes
- wearing an immobilizing boot or cast
Surgery can also be used to treat Haglund’s deformity if less invasive methods don’t work. During surgery, your doctor will remove the excess bone from your heel. The bone may also be smoothed and filed down. This reduces the pressure on the bursa and soft tissue.
You may be given a general anesthesia that will put you to sleep during the surgery. This is usually done if your Achilles tendon is damaged and your doctor needs to fix it.
After surgery, it will take up to eight weeks for you to completely heal. Your doctor will likely give you a boot or cast to protect your foot. You may also need to use crutches for a few days or weeks.
The cut will have to remain bandaged for at least seven days. Within two weeks, your stitches will be removed. Your doctor may want to get an X-ray of your foot on follow-up visits to ensure that it’s healing properly.
You can lower your risk of developing Haglund’s deformity by taking care of your feet:
- Avoid shoes with tight, stiff heels, especially for long periods of time.
- Avoid running on hard surfaces or uphill.
- Wear open-back shoes.
- Wear fitted, padded socks with non-slip soles.
- Perform stretching exercises to prevent tightening of the Achilles tendon.
With proper treatment, your pain should go away. While some people may see their symptoms reappear, taking the precautions listed above will help reduce your chances of getting Haglund’s deformity again.