Treatment options for Haglund's deformity in the foot

Haglunds deformity is a painful problem that occurs at the back of the heel bone. The bone at the back of the heel bone is enlarged and rubbing from the shoes makes it painful. A bursitis may develop from that rubbing that can become quite swollen and painful. The symptoms are made worse with the wearing of shoes. There is a lot of natural variability in the shape of the bone at the back of the heel bone and some people just have more prominent bone at the back of the heel than others.

The most important way to treat Haglunds deformity is to get the pressure off the painful area at the back of the heel bone. The best way to do that is to not wear shoes, or at least, wear shoes that have an open heel area. As the heel counter on a shoe is part of the cause, not wearing the shoes or using an open heel shoe is going to be very effective at removing that pressure. However, not wearing shoes is not always going to be that practical and there are plenty of times when we have to wear them. In these cases, try and select shoes that are very flexible in the heel counter area that cups the heel. There are now a number of running shoes on the market that are quite flimsy in the heel and place minimal pressure on the back of the heel. If you are still somewhat restricted with the use of footwear, then you can make pads out of podiatry felt that can help get pressure off the back of the heel. These pads can be shaped like a donut with a hole in them or like a horseshoe. The idea of these pads is that they get the pressure off the painful area. The pad can be stuck on the foot or stuck on the inside the heel area of the shoe. If this felt helps, then more permanent type pads made from a rubber like materials can be glued into the back of the shoe for the longer term. Another option is to use a sock like sleeve that has a layer of silicone gel in it that goes over the painful Haglunds deformity. This cushions the painful area and reduces the rubbing and friction on it. Sometimes a simple heel raise in the shoe can be used. This helps by lifting the foot up and moves the bony prominence away from the irritating part of the heel counter. Sometimes other treatment such as anti-inflammatory drugs and cortisone injections into the inflamed bursa may be needed to settle down the symptoms. If these conservative treatment options do not help, there are surgical options. These options can be somewhat difficult as the Achilles tendon attaches to the part of the heel bone that the deformity occurs at. The surgical options include cutting out the bursa and removing the prominent piece of bone. Due to that involvement of the Achilles tendon, the rehabilitation after the surgical can take a while, but the results a generally good.

Craig Payne is a University lecturer, runner, cynic, researcher, skeptic, forum admin, woo basher, clinician, rabble-rouser, blogger and a dad.