Haglund's disease, i.e. sterile heel tumor necrosis, gives characteristic symptoms: sharp heel pain, intensifying when the foot is bent, thickening or swelling of the skin at the site of the discomfort and soreness when putting on shoes, especially covered shoes. What are the causes of Haglund's disease? What is its treatment?
Haglund's disease , i.e.aseptic necrosis of the calcaneus tumorin the advanced stage is so troublesome and prevents normal functioning that patients rarely they delay visiting a doctor. Keep in mind, however, that not every pain in the heel area is a harbinger of Haglund's disease, and luckily it doesn't happen very often. It mainly concerns children and adolescents in the period of dynamic growth (between 8-14 years of age) and people practicing sports recreationally, especially those disciplines that burden their feet, e.g. running or tennis.
Haglund's disease is caused by arterial ischemia that affects the back of the heel. As a result, there is slight bone necrosis and, over time, degeneration of the calcaneus. A bone growth of the calcaneus is formed, which causes pain under pressure. If the disease occurs in children and adolescents, it is most often related to the abnormal growth of the heel bone, and in adults - it arises as a result of overloading during sports or after all kinds of injuries that cause injuries or micro-injuries of the heel. Some doctors are of the opinion that the inborn predisposition to develop aseptic tumor necrosis of the calcaneus is not without significance.
Haglund's disease: symptoms
The first symptoms can be very mild, e.g. slight blistering of the heel, slight pain when putting the foot on the ground, especially when walking or running, unpleasant pressure on the heel when putting on shoes. Symptoms appear periodically, sometimes they pass, or at least they are not bothersome enough to force you to act immediately. This is why sterile calcaneal tumor necrosis can take up to a year and a half to develop before more severe symptoms develop. There is no need to delay the visit to the doctor if there is significant swelling of the painful area, lumps, and above all, when severe pain in the heel accompanies the simplest activities, e.g.putting on shoes or walking. Occasionally, prolonged and untreated aseptic necrosis of the calcaneus tumor may additionally lead to inflammation of the Achilles tendon. That is why it is so important to consult a doctor about any excessively prolonged heel pain.
Haglund's disease: diagnosis and treatment
Severe heel pain does not always mean Haglund's disease. For example, the heel spur gives similar symptoms and only the X-ray examination will give an answer to the question of what disease we are dealing with. If it turns out that it is a sterile necrosis of the calcaneus tumor, the doctor must decide whether it is enough to relieve and rehabilitate the affected area or whether surgical intervention is necessary.
However, non-invasive treatment is usually first attempted. It consists mainly in relieving the heel, i.e. using comfortable footwear, preferably shoes without a heel or with a flexible heel counter, sometimes also with a soft heel cup and absorbing the pressure of the foot. The doctor may also recommend wearing special orthopedic insoles that support the longitudinal arch of the feet, which will relieve the painful area and speed up treatment. At this time, you also have to give up sports, which aggravate the symptoms of the disease. Most often, anti-inflammatory drugs and even steroids are used simultaneously.
In the case of Haglund's disease, the orthopedic surgeon may refer you to rehabilitation, which also gives the desired results. Treatments and appropriately selected exercises mean that the prognosis for aseptic heel tumor necrosis is good. However, if they do not bring the expected treatment results, a surgical procedure should be considered.
The operation consists in removing the growths in the heel tumor. At the same time, thanks to the methods used during the procedure, the proper compaction of the tissue is restored, which in turn ceases to exert pressure on the affected area. For several weeks, the patient has a partially immobilized foot, and the recovery usually takes about 6 weeks. However, it is important to discuss with your doctor what kind of sport you can do after the surgery, so that no complications or recurrence of the disease occur.