Haglund's deformity is a relatively common condition affecting young women primarily but can affect older men and women as well. It is often a hereditary problem that can be aggravated by shoes. A bony enlargement on the back of the heel causes the severe pain characteristic of the deformity. In addition, shoe irritation can lead to the formation of a bursitis, in which case the area becomes quiet red and inflamed. Often times, excessive pronation or excessive movement while walking causes the heel to rub against the back of the shoe. This prolonged irritation causes the formation of an enlarged bump and overlying skin irritation. Sometimes, the bump can be caused by a bone spur growing within the Achilles Tendon. This is more problematic than Haglund's Deformity due to a more extensive surgery to repair the bone spur problem.
Conservative care includes the wearing of soft cushion on the back of the heel, heel lifts, orthotics or shoe gear changes. A local injection of cortisone will help relieve a painful bursitis but only if the injection is distal to the insertion of the Achilles Tendon. Often times, surgery will be necessary because once the bone is enlarged or the spur is formed the pain continues despite conservative treatment. Experience has shown that pump bump surgery is very successful.
Surgery is usually performed at the hospital or surgery center. Because the bump is in the way of the Achilles tendon, the tendon may have to be partially removed from the heel bone. After the bump is gone the tendon may have to be reattached to the bone with a screw or anchor. Every attempt is made to avoid placing hardware in the foot during surgery. If your tendon needs to be reattached then this will require walking in a walking boot and crutches for four weeks. If the tendon doesn't have to be removed then immediate walking in a cam walker is allowed.