Treatment of Haglund’s Syndrome

About the disease

Haglund’s syndrome is a deformity of the back of the heel that is caused by wearing stiff or uncomfortable footwear over a period of time. The bony section of the heel becomes enlarged, causing a bump to form as it continuously rubs against the shoe.  If not treated in time, Haglund’s syndrome can turn into bursitis, which is a more serious and painful inflammation.

Bursitis develops when the fluid-filled sac that is located between the tendon and the bone becomes inflamed. Bursitis can also develop when calcium deposits build up in the heel bone. This is most likely to occur in people with a previous history of Haglund’s syndrome.

Symptoms

• Bump at the back of the heel (commonly, both feet are affected)
• Pain in the heel that is especially prominent when wearing closed footwear
• Swelling of the heel
• The skin in the affected area is red and sore

Diagnosis

• During a general examination, the doctor will examine the bump on the patient’s heel bone to see if it is inflamed and radiates pain upon touching. The doctor will also look for signs of inflammation around the fluid-filled sac between the tendon and the heel bone, which can indicate the appearance of bursitis.
• An X-ray is the most reliable test for diagnosing Haglund’s syndrome.

Treatment

• Conservative treatment is usually sufficient to get rid of the painful bump. The patient may be required to wear special orthopedic shoes or customized shoe inserts that are designed to reduce pressure on the heel.
• The patient may be prescribed special nonsteroidal anti-inflammatory drugs for pain relief. Applying ice on the bump each day can also be helpful.
• Open surgery on the ankle joint is performed if the protruding bone deformity needs to be removed or filed down. This will reduce the pressure on the soft tissue of the heel.

Authors: Dr. Vadim Zhiliuk, Dr. Sergey Pashchenko