Bursitis (ber-SEYE-tis) is swelling and pain of a bursa. A bursa is a fluid-filled sac that acts as a cushion or shock absorber between a tendon and a bone. A tendon is a cord of tough tissue that connects muscles to bones. Normally a bursa has a small amount of fluid in it. When injured, the bursa becomes inflamed (red and sore) and may fill with too much fluid. Achilles (ah-KIL-eez) tendon bursitis is a type of ankle bursitis when the bursa between the Achilles tendon and the heel becomes inflamed. You may have Achilles bursitis and tendonitis (inflamed tendon) at the same time.
Bursitis of the Achilles tendon is caused by the irritation and inflammation of the retrocalcaneal bursa, a small fluid-filled sac located in the back of the ankle that acts as a cushion and lubricant for the ankle joint. Possible causes of Achilles tendon bursitis include aging, Factors related to the aging process, including the onset of rheumatoid arthritis and gout, can deteriorate the bursa. Overuse of ankle. Excessive walking, uphill running, jumping, and other aggressive exercise regimens, especially without proper conditioning, can cause irritation to the bursa. Trauma. Sudden injury to the ankle joint, or trauma caused by rigid or improperly fitted shoes, can increase the chances of developing bursitis.
Pain in the heel, especially with walking, running, or when the area is touched. Pain may get worse when rising on the toes (standing on tiptoes). Red, warm skin over the back of the heel.
Obtaining a detailed history from the patient is important in diagnosing calcaneal bursitis. The following complaints (which the physician should ask about during the subjective examination) are commonly reported by patients.
Other inquiries that the physician should make include the following. The clinician should ask about the patient’s customary footwear (whether, for example, it includes high-heeled shoes or tight-fitting athletic shoes). The patient should be asked specifically about any recent change in footwear, such as whether he/she is wearing new athletic shoes or whether the patient has made a transition from flat shoes to high heels or vice versa. Individuals who have been accustomed to wearing high-heeled shoes on a long-term basis may find that switching to flat shoes causes increased stretch and irritation of the Achilles tendon and the associated bursae. The specifics of a patient’s activity level should be ascertained, including how far the patient runs and, in particular, whether the individual is running with greater intensity than before or has increased the distance being run. The history of any known or suspected underlying rheumatologic conditions, such as gout, rheumatoid arthritis, or seronegative spondyloarthropathies, should be obtained.
Non Surgical Treatment
Here are some of the most effective treatments for infracalcaneal bursitis Temporarily avoiding weight-bearing activities that put stress or strain on the heel bone can very helpful in treating infracalcaneal bursitis. PRICE (protection, rest, hot/cold contrast compresses, compression, and elevation) is another good acute management technique for this foot problem. Changing footwear is an effective long-term prevention and treatment tool for infracalcaneal bursitis. Shoes that possess a flat support base from heel to toe, a sufficiently wide toe box to accommodate natural toe splay, and a flexible sole that can be easily bent or twisted are best for preventing and managing infracalcaneal bursitis. An integrated approach to this problem usually involves the use of padded socks or heel cups to help reduce pressure, friction, and inflammation under the heel. Natural anti-inflammatory agents can also be helpful in quelling inflammation, reducing pain, and improving treatment times for infracalcaneal bursitis. In rare cases, more aggressive treatment methods may be required, such as cortisone injections or surgery to drain the bursal sac. Always consult your physician before beginning any healthcare regimen designed to treat infracalcaneal bursitis.
Surgery is rarely done strictly for treatment of a bursitis. If any underlying cause is the reason, this may be addressed surgically. During surgery for other conditions, a bursa may be seen and removed surgically.
After taking a history and performing a physical examination, your physician may order x-rays to rule out other disorders. Your doctor may administer injections of corticosteroids and a local anesthetic to reduce swelling and ease pain. Also, to reduce swelling, your physician may draw excess fluid from the bursa with a syringe and then tightly wrap and compress the joint with an elastic bandage. In severe, persistent cases surgery to remove the bursa may be necessary. For infectious bursitis, antibiotics will be prescribed.