Gout or Haglund Deformity / Syndrome 跟腱炎/黑格隆德氏病?

In June 2018, my heel was painful, I thought I was suffering gout, so I began research about gout, in particularly: what can be eaten and what should be avoided…

Nonetheless, the pain persisted. I went to see a private clinic doctor A on 2018-10-29. I told the doctor that I suspected that I was having gout attack. I showed the doctor the area affected. The doctor commented that base on my size, I would be a typical gout patient and claimed that my foot was “red, hot and swollen” but I don’t recall that my heel was that bad. The heel was swollen but definitely not “red and hot”. Nonetheless, I was charged $55 and prescribed with

1. Colchicine (500 mcg) tab – for gout
2. Famtodine (40 mg) tab – For Gastric
3. Calebrex (200 mg) tab – anti-inflammatory and pain

Where (2) & (3) must be taken together.

I finished the prescribed medication and the pain was relieved. However, it did not fully subsided.

On 2019-01-17, I went to another private doctor B for my heel pain and showed the affected area again. I told the doctor the similar thing – that I “think” I was having gout attack. This doctor is more senior and experience and asked where exactly were the pain. I showed him the tendon around the heel. He charged me $23 and prescribed me with

1. Colchicine – 0.6 mg for gout
2. Neodol-K 50 mg – anti-inflammatory painkiller

The doctor said that it might be due to long distance walking and suggested me to put on shoe with good shoe sole and support like running shoe.

I took 7 tablets of Colchicine and completed the 10 tablet of Neodol-K. Again, the pain was relieved but not fully subsided…

On 2019-01-28, I went to see a polyclinic doctor C for the same problem. To my surprise, the doctor told me that it might not be gout as from his perspective, gout would cause affect the entire joint. In my case, the “attack” was localized only on the Achilles Tendon! Hence, he believes the syndrome is known as Haglund’s Deformity!

He did not prescribe gout medication this time, as he believed that it would not help. Instead, he prescribed me with

1. Zolterol-Diclofenac – 75mg for painkiller
2. Zenpro – Omeprazole – 20mg for gastric

This doctor further explained to me that Haglund Deformity is due to excessive exercise, which I did for the past months on elliptical equipment…He said that could be the caused and he advised me to rest more.

I took 2 tablets of Diclofenac with Omeprazole but I felt there was no effect, so my pain was still there.

On 2019-02-04, I went to back to see doctor B again. I shared with him what doctor C’s assessment that my pain might not be due to gout…and asked for his opinion. He then said that sometimes it could be due to gout as the high urine acid could result in crystal that might deposit in the affected area.

I then shared with him that doctor C’s prescription was not effective as I didn’t feel any effect after taking the medication. Further to that, I told him that the previous medication he gave me, I could sense the “warm” around my foot after a few tablets.

He explained to me that – it could be due to inflammation. As the inflammation was cleared, it resulted in a better blood circulation, resulting in that “warm” feeling around the feet.

This time round, he changed his medication and charged me $33 and prescribed me with:

1. Soden Naproxen Sodium 275 mg – painkiller
2. Anarex: (to relieve pain associated with muscle spasm such as strains and sprains)
   • Orphenadrine Citrate – 35 mg
   • Paracetamol BP – 450 mg

This is the most effective medication among all that I have taken thus far. As after I took the medicine, the pain subsided. But on 2019-02-08, I walked substantially with an office shoe…and I felt the pain by that evening… As I examined the shoe, I noted that the heel of the shoe, both left and right were already wear out.

I took just a tablet on that night and as I woke up the next day, I felt the pain is almost gone. When I put on with another shoe, the pain did not come back!

Based on the above and as I analyse through my experience, I am now in strong opinion that the cause of the pain is due to shoe’s wear out. It appears to me that, there is a high tendency for doctors to treat the heel pain as gout attack.

The general advise here is:

1. If there is a pain in the heel, change the shoe first before consulting a doctor.
2. Gout attack will make one’s feet look “RED, HOT and SWOLLEN”.