Haglund’s deformity is a condition that affects the heel of the foot. It happens when there is a bony enlargement on the back of the heel, often caused by the rubbing of shoes against the area. The main reason for this bump is stress on the heel from activities that involve jumping or running. Some people are more likely to develop Haglund’s deformity due to the shape and structure of their feet. This condition is relatively common among individuals who are physically active, especially runners and certain athletes.
There are several factors that contribute to the development of Haglund’s deformity. One important factor is the anatomy of the foot. People with a high arch or a tight Achilles tendon may be more susceptible to this condition. These structural features can increase the pressure on the heel, leading to irritation and the formation of the bony bump (Vaishya et al., 2016). Additionally, repetitive stress from activities like running, dancing, or even walking can make the condition worse. Whenever the heel strikes the ground or is pushed against the back of shoes, it can create friction and pressure, which increases the risk of developing Haglund’s deformity.
Footwear also plays a significant role in the formation of this deformity. Wearing shoes that are too rigid or have a stiff back can cause the heel to rub against the shoe, leading to irritation. High-heeled shoes or poorly fitted athletic shoes are common culprits. This is particularly a problem for people who wear these shoes frequently, as the continuous pressure can inflame the soft tissue surrounding the heel and contribute to the development of Haglund’s deformity (Agyekum & Ma, 2015).
Individuals with Haglund’s deformity often experience several symptoms. The most common symptom is pain at the back of the heel. This pain is usually aggravated by movement or wearing shoes that rub against the area. People may also experience swelling around the heel, redness, and tenderness, which can make it uncomfortable to walk or stand for long periods. Limited mobility is another issue; some individuals may find it difficult to perform daily activities that require prolonged standing or walking (Tu & Bytomski, 2011).
The impact of these symptoms on a person’s quality of life can be significant. Pain and discomfort can interfere with work, leisure activities, and exercise. Simple tasks, such as walking to the bus stop or doing household chores, can become challenging. This limitation often leads to a more sedentary lifestyle, which can have further health implications, such as weight gain and decreased physical fitness (Fauzi, 2022). Overall, Haglund’s deformity can create a cycle of pain and decreased mobility that affects not only physical health but also emotional well-being, making it an important condition to understand and address., When treating Haglund’s deformity, there are different options available depending on the severity of the condition. For many patients, conservative measures are first-line treatments. These include physical therapy and the use of orthotic devices. Physical therapy focuses on exercises that can strengthen the muscles around the heel and improve flexibility, which may help relieve discomfort. Orthotics, such as specially designed shoe inserts, can reduce pressure on the heel and provide better support for the foot. These non-invasive treatments can be very effective for some individuals, allowing them to regain normal function and improve their quality of life.
In addition to physical therapy and orthotics, cortisone injections are another option for managing Haglund’s deformity. Cortisone is a powerful anti-inflammatory medication that can be injected directly into the affected area. This treatment can quickly relieve pain and reduce inflammation (Lotliker et al., 2024). Many patients experience significant relief from their symptoms, allowing them to return to daily activities with less discomfort.
However, while cortisone injections can provide short-term relief, there are important long-term implications to consider. Frequent use of cortisone can lead to tissue weakening and damage. This means that while injections can help manage symptoms, they should not be relied on as a sole treatment for Haglund’s deformity. Over time, relying on cortisone may mask the underlying issues and prevent individuals from seeking more effective long-term solutions.
For cases where conservative treatments do not provide sufficient relief, surgical options may be necessary. Surgery generally involves removing the bony bump at the back of the heel and possibly repairing any damaged tendons or tissue. Although surgery can lead to a significant improvement in mobility and pain levels, it requires a longer recovery period and carries risks, like any surgical procedure.
It is crucial for patients to work closely with their healthcare providers to decide on the most appropriate treatment based on their specific situation. A patient-centered approach takes into account not only the physical aspects of mobility but also how the condition affects overall quality of life. Factors such as work, hobbies, family activities, and mental well-being should all be considered in the treatment plan (Choo et al., 2020; Flores et al., 2024).
Finding the right approach can lead to improved mobility, allowing individuals to participate in the activities they love without pain. When patients manage their Haglund’s deformity effectively, they often notice a general improvement in their health. Being able to move without discomfort can lead to better physical fitness, enhanced social interactions, and a more fulfilling life overall (Tu, 2018). By focusing on both the function and the quality of life, healthcare providers can guide patients toward a better treatment path that suits their needs.
Citations:
Tu, P., 2018. Heel pain: diagnosis and management. American family physician, 97(2), pp.86-93. https://www.aafp.org/pubs/afp/issues/2018/0115/p86.html
Agyekum, E.K. and Ma, K., 2015. Heel pain: A systematic review. Chinese Journal of Traumatology, 18(03), pp.164-169. https://mednexus.org/doi/abs/10.1016/j.cjtee.2015.03.002
Tu, P. and Bytomski, J.R., 2011. Diagnosis of heel pain. American family physician, 84(8), pp.909-916. https://www.aafp.org/pubs/afp/issues/2011/1015/p909.html
Fauzi, A., 2022. Haglund Deformity: Diagnosis and Treatment. Cermin Dunia Kedokteran, 49(10), pp.548-551. https://cdkjournal.com/index.php/cdk/article/view/303
Vaishya, R., Agarwal, A.K., Azizi, A.T. and Vijay, V., 2016. Haglund’s syndrome: a commonly seen mysterious condition. Cureus, 8(10). https://www.cureus.com/articles/5240-haglunds-syndrome-a-commonly-seen-mysterious-condition.pdf
Yuen, W.L.P., Tan, P.T., Kon, K.K.C. and Kon, C., 2022. Surgical treatment of Haglund’s deformity: a systematic review and meta-analysis. Cureus, 14(7). https://www.cureus.com/articles/106826-surgical-treatment-of-haglunds-deformity-a-systematic-review-and-meta-analysis.pdf
Flores, D.V., Goes, P.K., Damer, A. and Huang, B.K., 2024. The heel complex: anatomy, imaging, pathologic conditions, and treatment. Radiographics, 44(4), p.e230163. https://pubs.rsna.org/doi/abs/10.1148/rg.230163
Wang, J., Zeng, X. and Ma, X., 2020. Advance of diagnosis and treatment of Haglund syndrome. Zhongguo xiu fu Chong Jian wai ke za zhi= Zhongguo Xiufu Chongjian Waike Zazhi= Chinese Journal of Reparative and Reconstructive Surgery, 34(4), pp.518-523. https://europepmc.org/article/med/32291992?utm_medium=email&utm_source=transaction&client=bot&client=bot
Lotliker, S.D., Verma, S., Bhalla, A., Shah, M., Mekewar, S. and Sharma, A., 2024. Heel Pain Management in Haglund’s Deformity Targeting Sural Nerve Branches under Ultrasound Guidance: Case Report. Journal of Orthopaedic Case Reports, 14(2), p.12. https://pmc.ncbi.nlm.nih.gov/articles/PMC10898712/
Choo, Y.J., Park, C.H. and Chang, M.C., 2020. Rearfoot disorders and conservative treatment: a narrative review. Annals of palliative medicine, 9(5), pp.3546552-3543552. https://apm.amegroups.org/article/view/48795/html
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