Haglund Heel

Haglund heel (Haglund's deformity) is characterised by a prominent bony projection (bump) on the back of the heel caused, in most cases, by chronic pressure on the back of the heel from shoes. Haglund's deformity is frequently accompanied by inflammation of the bursa (sac of fluid) on the back of the heel and can be extremely painful. The condition can make it impossible to wear normal shoes.

Diagnosis

An X-ray of the heel should be obtained. MRI studies should be performed if co-involvement of the Achilles tendon, which attaches at the same site, is suspected.

Treatment

Conservative treatment can be attempted first if chronic irritation of the heel is suspected. Conservative measures include shoe modification (e.g. heel lifts, heel cushions and, in some cases, removing the back of the shoe). The aim is to stop the chronic pressure on the heel and give the foot a chance to recover. If all conservative measures fail to achieve any significant improvement of symptoms, then heel surgery can be considered. The objective of surgery is "indirect" removal of the deformity. This is accomplished by removing a wedge of heel bone taking care not to damage the site where the Achilles tendon attaches to the heel. After surgery, the incision must be protected. It is not possible to wear normal shoes for at least one month after surgery.