Haglund's deformity is a calcification that can form at the back of the heel as a result of pressure from stiff-backed shoes. It can become painful, making it hard to walk, and may also interfere with the normal fit of shoes. There are a number of treatments available to manage Haglund's deformity, and it can help to see a foot and ankle specialist to get detailed advice on treatment options and how to prevent recurrence of the growth after treatment.
Certain risk factors can make this condition more common. Patients who walk on the outside of the heel, have a tight Achilles tendon, or have high arches are more likely to develop Haglund's deformity. Likewise, patients who wear high heels, ice skates, and other shoes with a rigid back are more likely to experience this problem; in fact, it is sometimes known as the “pump bump,” a reference to the fact that people who wear pumps on a regular basis commonly experience it.
A doctor can palpate the foot and ankle to diagnose the growth, and may request a medical imaging study of the area. Haglund's deformity may also be accompanied with heat, tenderness, and swelling, showing active inflammation in the area. Immediate treatments usually include rest, icing to bring down swelling, and non-steroidal anti-inflammatory drugs. The doctor may recommend changing footwear or wearing supports in shoes to address fit problems and increase comfort.
Steroidal treatments, particularly injections, are not recommended in this case, although they are a standard treatment for inflammation. There are concerns that using drugs like cortisone could increase the risk of rupturing the Achilles tendon, which would expose the patient to serious injury and discomfort. Physical therapy can help address the inflammation, as can immobilization in extreme cases. If the patient does not respond to these treatments, the last line of options includes surgery to excise the growth.
Patients can reduce their chances of developing Haglund's deformity by wearing shoes that fit properly and changing footwear regularly. This will limit inflammation caused by the same shoe wearing on the same spot, day after day. Patients who need to wear stiff shoes for professional reasons can meet with a doctor to discuss mitigating options like padding the heel, wearing gentler shoes when not at work, and even kicking work shoes off when it is possible to do so discreetly, to give the feet and ankles a rest.
