Haglund’s deformity is a foot condition marked by a prominent enlargement of the bone at the back of the heel, near where the Achilles tendon inserts into the heel bone. Along with the prominent bump, you may observe heel pain, redness, swelling, tenderness, and difficulty wearing shoes comfortably.
Although the enlarged bone is not necessarily painful on its own, the pressure it places on the surrounding soft tissues can lead to painful bursitis. Haglund’s deformity is especially common in teen and young adult women, but it can happen to anyone.
Causes of Haglund’s Deformity
Haglund’s deformity also goes by the name “pump bump,” for an obvious reason—young women who wear pumps are especially likely to be affected. In truth, any style of shoe, boot, or skate for women or men with a hard back that places inordinate pressure on the back of the heel could be part of the problem. These shoe styles may or may not cause a bump to form in the first place, but the pressure they place on the back of heels can certainly aggravate the problem and increase your pain.
Genetic factors are also at work. Certain foot types or walking styles increase the risk of Haglund’s deformity, including high arches, tight Achilles tendons, or a tendency to walk on the outside of the heel. These conditions pull, tug on, and put pressure on the back of the heel more than other foot types.
Why Haglund’s Deformity is So Painful
Enlarged bones are not themselves painful, but put them in the wrong spot and then can cause pain in nearby softer tissues. That’s what happens with Haglund’s deformity.
Your body uses small, fluid-filled sacs called bursa to cushion and lubricate the spaces between bones, tendons, and muscles in a joint, allowing them to move without pain or friction. A Haglund’s deformity can push uncomfortably against the bursa behind your heel, irritating it and causing it to swell. When you wear hard-backed shoes you make the problem worse. This is what causes the sharp pain associated with Haglund’s deformity.
Fixing Haglund’s Deformity in Warren & Edison, NJ
There are many possible ways a treatment course can progress, based on the severity of the condition and your personal needs. However, we’ll always start with conservative care first.
Conservative treatment focuses on removing sources of pressure and relieving pain. It won’t get rid of the bony enlargement, but successful treatment will allow you to return to normal activities without further discomfort.
Non-surgical approaches may include:
- Wearing open-back or soft-backed shoes whenever possible, and avoiding hard-back styles like pumps.
- Wearing heel pads, heel lifts, or custom orthotics that correct biomechanical flaws and reduce pressure on the bump.
- Performing stretches and exercise to relieve tightness and tension in the Achilles tendon.
- Using over-the-counter anti-inflammatories and icing to manage pain when necessary.
- Temporarily immobilizing the foot with a cast or boot to allow the inflamed bursa time to heal.
Generally, we will want to thoroughly exhaust conservative alternatives first. However, if your pain does not respond to these measures, we can remove the bony enlargement via surgery. This will eliminate the primary source of the discomfort. The procedure is generally performed in our office and has an average recovery time of about two months, although that can vary based on many factors, including the severity of the original condition. It will be important for you to carefully follow all guidelines for post-operative care to ensure a quick recovery.
If a bony bump at the back of your heel is making life difficult, make an appointment to see Dr. Jyotsna Thapar. This condition will not get better without treatment, so early intervention is strongly recommended. Call (908) 222-8980 to set up a time at our South Plainfield/Edison, Hillsborough or Warren, NJ office.