Have you noticed a hard bump on the back of your heel that becomes painful when you wear certain shoes? If the area feels irritated, swollen, or tender where your shoe rubs against it, you may have a condition called Haglund’s deformity.

This condition involves a bony enlargement at the back of the heel bone. Although some people have no symptoms, the bump can cause friction and irritation around the surrounding soft tissues, especially when wearing rigid or tight-backed shoes.

Understanding what causes Haglund’s deformity and how it can be treated can help you find relief and prevent ongoing discomfort.

Haglund’s deformity is a bony prominence that develops near the back of the heel, close to where the Achilles tendon attaches. Because the bump can rub against the back of a shoe, it may irritate nearby tissues and contribute to pain and swelling.

The condition is sometimes associated with irritation of the bursa, a small fluid-filled sac that helps reduce friction around the heel. When this area becomes inflamed, the resulting symptoms may be described as retrocalcaneal bursitis or irritation related to the prominence.

Haglund’s deformity is not the same as an Achilles tendon injury, although both conditions can cause pain in a similar location. A clinical evaluation can help distinguish between them.

Symptoms can range from mild irritation to persistent discomfort that interferes with walking or physical activity. Common signs include:

• A noticeable, hard bump on the back of the heel.

• Pain when wearing shoes with stiff heel counters.

• Redness or swelling around the back of the heel.

• Tenderness where the shoe rubs against the bump.

• Irritation that worsens after walking, running, or standing.

• Discomfort near the Achilles tendon.

Some people notice that symptoms improve when they remove their shoes or switch to footwear that does not press against the affected area.

However, a bump at the back of the heel can have other causes. New, severe, or persistent pain should be evaluated rather than assumed to be Haglund’s deformity.

There is not always one identifiable cause. The shape of the heel bone, foot mechanics, footwear, and repeated pressure or friction may all contribute to symptoms.

Potential contributing factors include:

Foot structure: The natural shape of the heel bone may make some people more susceptible to irritation in this area.

Rigid or poorly fitting shoes: Shoes with stiff backs can repeatedly press against the bony prominence, increasing friction and discomfort.

Repetitive activity: Running and other activities that place repeated stress on the heel may aggravate the surrounding tissues.

Foot mechanics: Certain patterns of foot movement may influence how pressure is distributed around the heel.

Having a bony prominence does not necessarily mean it will become painful. Treatment is generally guided by your symptoms and how much the condition affects your daily activities.

A podiatrist will typically review your symptoms, examine the back of your heel, and assess the location of the tenderness and swelling. Imaging, such as an X-ray, may be recommended to evaluate the shape of the heel bone and help identify other possible causes of pain.

Because Haglund’s deformity can resemble Achilles tendinopathy or bursitis, an accurate diagnosis helps guide treatment and avoid addressing the wrong problem.

Treatment usually begins with conservative measures designed to reduce pressure, friction, and irritation.

1. Change your footwear. Shoes with a softer or lower back may reduce pressure on the bump. Avoiding footwear that repeatedly rubs against the heel can be an important first step.

2. Modify aggravating activities. Temporarily adjusting running, jumping, or other activities that worsen symptoms may help reduce irritation while the heel recovers.

3. Use appropriate padding. Heel pads or protective cushioning may help reduce friction from footwear. Make sure any padding does not create additional pressure on the affected area.

4. Consider orthotics when appropriate. Depending on your foot mechanics and symptoms, a podiatrist may recommend shoe inserts or custom orthotics to help manage pressure and improve foot support. Orthotics do not remove the bony prominence, but they may be useful for selected patients.

5. Discuss additional treatment options. If symptoms persist, your podiatrist may recommend further evaluation and other treatments based on whether the main source of pain is the bony prominence, the surrounding bursa, or the Achilles tendon.

If conservative treatment does not provide adequate relief and the condition significantly limits your activities, surgery to remove the prominence may be considered in selected cases. Surgery is generally not the first treatment option, and recovery depends on the procedure and the condition of the surrounding tissues.

Consider scheduling an evaluation if the bump on your heel is painful, the area remains swollen, your shoes consistently irritate it, or the discomfort interferes with walking and exercise.

Seek prompt medical attention if you experience sudden severe pain, a popping sensation, or difficulty pushing off your foot, as these symptoms can indicate a more serious Achilles tendon injury.

At Vargas Foot Specialists in Sugar Land, Texas, Dr. Marco A. Vargas, DPM, FACFAS, DABFAS, evaluates heel pain and other foot and ankle conditions to help patients understand the cause of their symptoms and explore appropriate treatment options.

If you are looking for a podiatrist in Sugar Land or heel pain treatment in Houston, call (281) 313-0090 to schedule an appointment.

At Vargas Foot Specialists, we are proud to provide care in both English and Spanish. Dr. Marco A. Vargas and our team welcome patients from Sugar Land and the greater Houston area, including Katy, Richmond, Missouri City, and Rosenberg.

We understand how important it is to communicate clearly about your symptoms and treatment options. Whether you prefer English or Spanish, our team is here to help you take the next step toward better foot health.