The Haglund’s heel (Haglundexostosis) is a bony protrusion on the lateral or rear edge of the heel bone in the insertion area of the Achilles tendon. The affected persons feel a pressure pain in the corresponding area of the heel, especially when wearing shoes. The skin above the Achilles tendon attachment is often reddened and swollen. The causes of hail lundexostosis include unsuitable footwear and a genetic predisposition is also being discussed. If the suspicion of a hail lundexostosis is confirmed by orthopedic examinations, an imaging diagnosis is made by means of ultrasound, x-ray or CT.
Treatment options
The symptoms caused by a Haglund heel can range from complete freedom from pain and discomfort to severe pain. Accordingly, there are various options for the therapy of the Haglund’s heel, depending on its characteristics. In the case of light forms, even the choice of the right (possibly orthopedic) footwear in combination with insoles or padding can contribute to a significant improvement. Physiotherapeutic exercises and pain and anti-inflammatory medication can also lead to success. If these measures are only temporarily effective, the actual cause of the disease must be treated, either by surgery or non-invasively by radiation.
Irradiation
When irradiating a Haglund’s heel, there is the possibility of shock wave therapy on the one hand and X-ray irradiation on the other hand. Shock wave therapy, which has already become established for the destruction of kidney stones, involves the application of targeted shock waves (high-energy pressure waves) to a tissue area. The affected tissue now sets surrounding tissue in vibration.
With increasing treatment duration, this leads to increasing instability in the irradiated bone. The ossification of the tendon attachment in the Haglund’s heel is thus practically dissolved, it “crumbles”. A session lasts only a few minutes and is not painful for the patient, so that anesthesia or narcosis is not necessary.
Several sessions are usually necessary to achieve the desired reaction in the tissue. In Germany, shock wave therapy for the treatment of the Haglund’s heel does not have to be paid for by the statutory health insurance companies, so the patient may have to pay for the treatment himself. If several sessions are necessary, costs of several hundred Euros must be expected.
It is possible to submit an application to the health insurance company for the assumption of costs, which can be approved at their discretion. You can obtain information on this from your attending physician for your particular case. The procedure offers good chances of recovery after several sessions, but even after achieving freedom from pain and discomfort, a recurrence of the ossification cannot be ruled out.
As a non-invasive treatment option, shock wave therapy is generally very low-risk and in most cases free of side effects. In rare cases, irritation of the surrounding tissue may occur, such as swelling or superficial skin bleeding. Consequential damage such as injury to bony structures, nerves or vessels is very rare and not to be expected if the treatment is carried out properly.
