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Haglund’s Disease

What is it?

A Haglund’s deformity is a large bony bump that develops in the back of the heel. It is believed to result from repetitive irritation of the Achilles tendon as it attaches to the back of the heel and/or irritation from shoes. The bony bump can range from small to very large in some cases. Sometimes there is no pain associated with the bump, whereas in other cases, it can be very painful and associated with inflammation. Often there may be associated inflammation of the bursa (small pocket of fluid) in the back of the heel; this is known as retrocalcaneal bursitis. Insertional Achilles tendinitis can be seen with it, as well.

What symptoms does it cause?

Haglund’s disease results in pain in the back of the heel at the bony bump. There might be mild swelling or redness associated with it. It hurts to walk or push off. Often there is associated Achilles and/or calf tightness.

How is it diagnosed?

The diagnosis is made by physical examination and X-ray.

How is it treated?

Physical therapy and stretching the Achilles/calf are key to the treatment of this condition. In severe cases, a period of immobilization may be needed to calm down the inflammation prior to initiating therapy. A heel lift can be used temporarily to calm down the pain. Anti-inflammatories are often used to decrease the inflammation. In rare cases if the pain is severe and persistent despite a sufficient course of these treatments, then surgery can be considered to remove the bony bump.