Haglund’s disease treatment and care pathway
Dr Lopez is a specialist in Haglund’s disease and its treatment. He will know how to advise the most suitable treatment for you.
Before knowing if Haglund’s surgery is necessary, it is essential to recognize the symptoms and risk factors in order to make an accurate diagnosis.
Haglund’s disease is a malformation of the back foot and more specifically of the heel bone. This malformation is characterized by a calcaneal bone high, pointed, protruding, directed at the top and back of the foot. This causes inflammation of the Achilles tendon due to friction between the shoe and the posterior part of the calcaneus (heel bone).
The pathology is usually bilateral and therefore affects both feet at the same time.
Haglund’s disease is characterized by several symptoms:
- Pain in the heel
- Posterior prominence of the heel bone
- Onset of insertion Achilles tendinitis
- Palpation pain
- Limited sports practice
- Redness and swelling of the heel
- Stiffness in the back of the heel
- Onset of retro-calcaneal bursitis
In addition to visible symptoms, pain is one of the most common symptoms of Haglund’s disease. The pain can be permanent, uncomfortable when walking and may be accompanied by limping in some cases. Redness, heel swelling, skin lesions and pain are therefore among the main warning signs to take into account in order to consider a consultation as soon as possible.
Once these symptoms are present, wearing shoes becomes very difficult, if not impossible depending on the stage and extent of the malformation.
Dr Julien Lopez will direct you to the medical or surgical treatment adapted to your case.
Risk factors for Haglund’s disease are numerous. Wearing inappropriate footwear is one of the main causes of the onset of the condition. These include safety footwear, rigid buttress footwear or high-heeled footwear.
Other malformations can also promote the appearance of this pathology such as hollow foot for example.
Some people are more affected by Haglund syndrome. The disease can affect athletes regardless of the sport they play. However, some studies show that a traumatic sports practice for the foot joint (football, tennis, running, etc.) increases the chances of developing Haglund’s disease.
People between the ages of 20 and 30 are generally more affected than other age groups.
In order to diagnose Haglund syndrome, Dr. Julien Lopez carries out various medical imaging tests.
Radiography is usually the first exam performed. The objective of this examination on the profile foot is to detect possible deformation of the calcaneus bone and tendinopathy of the Achilles tendon.
Ultrasound is an additional reference exam to confirm the diagnosis but also to select the most suitable medical approach. It allows initially to identify the presence of tendinopathy at the rear of the foot. Tendinopathy is characterized by inflammation of the tendon. The presence of tendinopathy will modify the management of the condition and will lengthen the surgical follow-up in case of the operation of Haglund and its exostosis.
If the symptoms described by the patient suggest tendinopathy but the ultrasound did not reveal it, then MRI will be recommended.
Haglund’s disease surgery is often necessary. Indeed, there is little chance that Haglund’s disease will heal spontaneously. It is normal to want to go to a reputable surgeon to operate on Haglund and benefit from a suitable treatment.
Dr. Julien Lopez has the necessary skills to support you throughout your care journey: first consultation, diagnosis, medical treatment, surgery, recovery…
The medical treatment of Haglund’s disease is systematically the first line of treatment. According to your case and the evolution of the malformation, Doctor Julien Lopez will propose different treatments:
- Adaptation of the shoe. It is recommended to wear wide and comfortable shoes that do not put any pressure on the heel.
- Wearing orthopedic soles or heel braces. The soles will help to position the calcaneus more horizontally and distribute the load over the entire foot.
- Taking non-steroidal anti-inflammatory drugs locally.
- Rehabilitation through stretching and massages with the aim of preserving the flexibility of the joint and limiting inflammation.
If medical treatment fails, the pain persists, or the deformity is too great, Dr. Julien Lopez will discuss Haglund and Achilles Heel surgery. Trained in the most recent surgical techniques, Doctor Julien Lopez will be able to select the approach best suited to your case.
Different techniques can be used for the surgical treatment of Haglund.
The first method is to remove excess bone from the calcaneus by open incision or arthroscopy. Haglund’s arthroscopic surgery will always be preferred by Doctor Lopez in order to limit the pain felt and facilitate the recovery process. In this case, the surgery is performed using a camera slid into the joint. Surgical actions can also be performed on the tendon if it is affected.
For Haglund’s disease, surgical treatment is performed on an outpatient basis and usually takes 30 minutes. To limit post-operative pain, the operation can be performed under general anesthesia or under loco-regional anesthesia.
In some cases, a calcaneal osteotomy may be preferred.
In the case of Haglund’s disease, surgery requires post-operative care.
Support and resumption of walking are possible immediately or prohibited for 4 to 6 weeks depending on the nature of the operation.
The ankle is most often immobilized in a walking boot. This will be prescribed by Dr. Julien Lopez during the consultation. The goal of the walking boot is to keep the foot at 90° flexion to optimize tissue healing.
The anesthesiologist will prescribe thromboprophylaxis to avoid the risk of phlebitis.
The dressing must be redone every 2 days until the foot is completely healed.
Following the operation, physiotherapy and self-rehabilitation sessions will be required for about 2 to 3 months to regain the full range of the ankle joint.
Resumption of work will be possible between 2 and 8 weeks after the surgery depending on the case.
You will be able to resume a sports activity 1 to 3 months after the operation of Haglund syndrome according to the surgical procedure performed.
In case of problems during the recovery process, Dr. Julien and his team are at your disposal to advise and answer your questions.
Regarding Haglund’s disease, the price of the operation depends on your insurance. A quote will be given to you by the secretary and then you must send it to your insurance.