Outward Indications Of Bursitis Of The Foot
Overview
A Bursa is a small fluid filled sac that forms in areas of extra rubbing and friction. They are usually present with a bone deformity as the bone is pressed against other structures like a tendon or against the ground as you walk. The bursa acts as a shock absorber and is a way for your body to protect you from damage. When this bursa or sac like structure becomes swollen and inflammed it is called bursitis. The bursa may be anatomical meaning normally present, or it may be adventitious meaning, only present because of a problem. Many bursa are present and do not cause pain.
Causes
The calcaneal bursa can become inflamed in patients with heel spurs or in patients with poor-fitting shoes (eg, high heels). Inflammation can occur secondarily from Achilles tendinitis, especially in young athletes. Patients exhibit tenderness to palpation of the bursa anterior to the Achilles tendon on both the medial and lateral aspects. They have pain with movement, which is worsened with dorsiflexion.
Symptoms
Pain and tenderness usually develop slowly over time. Applying pressure to the back of the heel can cause pain. Wearing shoes may become uncomfortable. The back of the heel may feel achy. Pain is exacerbated when the foot is pointed or flexed, because the swollen bursa can get squeezed. A person with retrocalcaneal bursitis may feel pain when standing on their toes. Fever or chills in addition to other bursitis symptoms can be a sign of septic bursitis. Though uncommon, septic retrocalcaneal bursitis is a serious condition, and patients should seek medical care to ensure the infection does not spread.
Diagnosis
Diagnosis of heel bursitis can be made by your health practitioner and is based on the following. Assessing the location of the pain by palpating the back of the heel. Assessment of any inflammation at the back of the heel. Assessment of biomechanics and foot function. Ultrasound or MRI can reveal inflammation of the retro calcaneal bursa.
Non Surgical Treatment
Orthotics may assist heel bursitis by providing stability to the heel, reduce any foot functioning abnormalities and provide extra support for the feet. The orthotic achieves this by maintaining correct foot posture, therefore facilitating normal functioning of the Achilles tendon. Icing the back of the heel post activity for temporary relief. Non-steroidal anti-inflammatory medication such as ibuprofen can reduce inflammation of the bursa. Stretching of the calf muscle may reduce the pulling on the heel by the Achilles tendon. Shoes that have an elevated heel may reduce pulling on the heel from the Achilles tendon. Resting the painful heel may reduce inflammation and pain. Surgical removal of the painful bursa is a last resort treatment when all other treatments have failed.
Surgical Treatment
Surgery is rarely need to treat most of these conditions. A patient with a soft tissue rheumatic syndrome may need surgery, however, if problems persist and other treatment methods do not help symptoms.