Haglund’s deformity is a bony enlargement on the back of the heel. Because it rubs against the shoe, it can often lead to painful bursitis, which is an inflammation of the bursa (a fluid-filled sac between the tendon and bone). The condition is often called “pump bump” because the rigid backs of pump-style shoes can create pressure that aggravates the enlargement when walking. However, any shoes with a rigid back can cause this irritation.
Haglund’s deformity can occur in one or both feet. The symptoms include:
- A noticeable bump on the back of the heel
- Pain in the area where the Achilles tendon attaches to the heel
- Swelling in the back of the heel
- Redness near the inflamed tissue
While non-surgical treatment of Haglund’s deformity can relieve pain and inflammation, it will not shrink the bony protrusion. Non-surgical treatments can include one or more of the following:
- Oral nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may reduce pain and inflammation.
- Applying an ice pack to the inflamed area, placing a thin towel between the ice and the skin. Use ice for 20 minutes and then wait at least 40 minutes before icing again.
- Exercises. Stretching exercises help relieve tension from the Achilles tendon.
- Heel lifts. Patients with high arches may find that heel lifts placed inside the shoe decrease the pressure on the heel.
- Heel pads. Pads placed inside the shoe cushion the heel and may help reduce irritation when walking.
- Shoe modification. Backless or soft backed shoes help avoid or minimize irritation.
- Orthotic devices to control the motion in the foot.
- Immobilisation. In some cases, casting may be necessary.
In some cases, surgery may be needed.