Where in Dubai
Dr. Subhash Ushakoyala, Specialist Orthopaedic Surgeon, sees patients with pain at the back of the heel at Grand Infinity Medical Center in Al Muteena, Deira, Dubai. Wear or bring the shoes that hurt most, such as work shoes, safety boots or trainers, so he can see where the back of the shoe presses on the heel. If you have had a heel X-ray before, bring the images and the report.
What is haglund's deformity?
Haglund's deformity is an enlarged bump of bone on the back of the heel, close to where the Achilles tendon attaches. The bump alone may cause no trouble. Pain starts when a shoe, or the tendon above it, rubs on the bump again and again. This can inflame the small fluid-filled cushion (bursa) between the tendon and the bone, or wear down the lower end of the tendon itself. The back of the heel then becomes sore, swollen and warm, and shoes with a stiff back hurt. Tight calf muscles and a lot of running add to the strain. People born with a larger bump are more likely to get heel pain as they get older. Most people improve without an operation, although it can take a few months.
Common signs
- A hard, tender bump on the back of the heel.
- Pain at the back of the heel that is worse in shoes with a stiff back.
- Swelling, warmth or redness where the Achilles tendon meets the heel.
- Pain at the back of the heel that builds with walking, running or stairs.
- Heel pain when you stretch your calf.
How Dr. Subhash approaches it
His services list includes the treatment of Haglund's deformity, the long-lasting pain at the back of the heel. Dr. Subhash first works out what is hurting: the bony bump, the inflamed bursa beside it, or the Achilles tendon itself. He examines the heel, checks how tight the calf is, looks at the shoes you wear, and arranges an X-ray to see the bump and any bone spur. He then explains a plan that starts with shoes, stretching and pain relief.
What to expect
Consultation
He asks when the pain started, what makes it worse, and about your work, sport and shoes.
Examination
He feels for tenderness and swelling at the back of the heel and checks how your calf and ankle move.
X-ray, and a scan if needed
An X-ray shows the bump and any bone spur. An MRI is sometimes used to look at the tendon if treatment is not working.
Treatment plan
Shoes that are soft or open at the back, heel lifts or pads, ice, calf stretches and anti-inflammatory pain relief. A physiotherapist can guide the exercises. A walking boot may be used for a short time if the pain is severe.
Review
He checks your progress. If the pain has not settled after about six months of this treatment, he explains whether an operation is worth considering.
Getting better
Every patient is different. These are typical milestones, not a promise; your own plan comes from your consultation.
- Most people improve without surgery, but it often takes a few months, and pain can last longer than three months.
- Daily calf stretches reduce the pull of the Achilles tendon on the heel.
- Shoes that do not press on the back of the heel, or a heel lift, ease the rubbing on the bump.
- After an operation to remove the bump and repair the tendon, most people walk in a boot or cast within about two weeks. The timeline depends on how much tendon is repaired.
Risks to know about
- Heel drop exercises suit pain higher up the Achilles tendon. Done for pain where the tendon meets the heel, they can make it worse.
- Wearing a walking boot for a long time weakens the calf muscle.
When to book a visit
Book a visit if pain at the back of the heel has not improved after two weeks of rest, ice and changing shoes, or it keeps coming back. Book sooner if the pain stops your normal activities, you have tingling or numbness in the foot, or you have diabetes. Go to emergency care straight away if you felt a sudden pop or snap at the back of the heel or calf, you cannot stand on tiptoe, or the foot or ankle has changed shape after an injury.
Where to book
Dr. Subhash sees patients at Grand Infinity Medical Center in Al Muteena, Deira, in north-east Dubai. The clinic is at Shop No. 4, next to the Grand Excelsior Hotel.
Grand Infinity Medical Center
Shop No. 4, next to Grand Excelsior Hotel, Al Muteena, Deira, Dubai, United Arab Emirates
DirectionsCall +971 58 599 7460WhatsApp
Questions patients ask
I wear safety boots for work. Can they cause pain at the back of my heel?
Shoes or boots that rub or cut into the back of the heel can irritate the area where the Achilles tendon attaches. Bring them to your visit. He can advise on padding, heel lifts or a better fit.
Is Haglund's deformity the same as a heel spur?
Not quite. Haglund's deformity is an enlarged part of the heel bone. A bone spur can also grow where the Achilles tendon attaches, often when the end of the tendon is worn. Both show on an X-ray, and both are usually treated without surgery first.
Which shoes help?
Shoes that are soft at the back, or open-backed, rub less on the bump. A heel lift or heel pad takes some strain off the tendon. Avoid shoes with a hard, stiff back while the pain settles.
Will I need an operation?
Most people do not. Surgery is considered only when the pain has not improved after about six months of non-surgical treatment. It removes the bump and any damaged tendon, and fixes the tendon back to the heel bone.
Book an appointment
His nurse answers the phone and WhatsApp.