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What is Haglund's disease?
Haglund's heel, otherwise known as Haglund's Deformity, is a condition in which a bony growth protrudes from the heel bone causing irritation and inflammation. Haglund's heel can vary in shape and size. The condition is not the result of a single injury, and depends more on physical activity. However, of course, this is not the rule, as heel pain also occurs in people who do not participate in sports. The pain can be aggravated when we wear ill-fitting footwear, especially a poorly shaped and overly stiff heel counter. Some scientific studies also report that to some extent Haglund's heel is also related to heredity and being overweight.
Symptoms of Haglund-Severa disease
The main symptom of Haglund-Severa disease, commonly known as Haglund's heel, is pain in the heel bump, with no obvious signs of swelling. Symptoms in the early stages of the disease are mild, causing only discomfort during walking. Heel pain most often occurs after exercise or in the morning, but is rarely experienced at night. Symptoms can occur bilaterally and last for a long time, until the growth of the foot is complete. Over time, the pain significantly increases and causes limping when walking. A deformity develops on the heel bump along with painful swelling. The next stage may be an inflammatory process manifested by significant redness within the Achilles tendon attachment. Haglund's heel is characterized by a noticeable lump on the posterior-top of the heel. This symptom should clearly prompt us to consult an orthopedist.
Treatment of Haglund-Severa disease
Haglund-Severa disease can already be confirmed on the basis of a physical examination, but X-rays need to be taken at diagnosis to be absolutely sure and to rule out other causes of heel pain, such as fractures. Haglund's heel, with proper diagnosis and early initiation of conservative treatment, offers a good prognosis for the patient. Treatment of Haglund-Severa Disease consists of a significant reduction in physical activity, rest, the use of lower limb stretching exercises and the use of ice compresses. Sometimes an orthopedist may administer nonsteroidal anti-inflammatory drugs. It is also important to modify footwear to reduce the irritating factor of the diseased bursa. Haglund's heel and the ailment associated with it does not entail the need to stop sports altogether. It can be practiced, but changing the type of exercise. Once the ailment is cured, a return to full physical activity is possible. Although treatment can be very long, it is fully effective. We are talking about reducing pain, because conservative treatment will not reduce the deformity on the heel bone itself.
Haglund's heel - when is surgery needed?
The orthopedist decides on surgery in the absence of clear results of conservative treatment, when the deformity of the heel bump is advanced. Surgical treatment consists mainly of removing the bony protrusion. Haglund's heel surgery can be performed using a traditional open surgical technique or a minimally invasive endoscopic technique, which causes fewer complications with wound healing after surgery and allows the patient to stand on the affected foot more quickly. After the operation, the doctor puts a plaster splint on the patient to minimize heel pain. It is very important to follow the instructions of the orthopedist and physiotherapist after the surgery. A return to physical activity occurs about 12 weeks after surgery.
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Other possible cases of pediatric orthopedics.
Bibliography:
- National Library of Medicine - Haglund’s Syndrome: A Commonly Seen Mysterious Condition - Monitoring Editor: Alexander Muacevic and John R Adler - Raju Vaishya, Amit Kumar Agarwal, Ahmad Tariq Azizi, Vipul Vijay - 2016
- Healthline - Haglund’s Deformity - Medically reviewed by William Morrison, M.D. — By Shannon Johnson — Updated on March 8, 2019
- Medical News Today - How to treat Haglund's deformity and other things you should know - Medically reviewed by Angela M. Bell, MD, FACP — By Jennifer Berry — Updated on January 5, 2022
