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Overview<br>Retrocalcaneal bursitis is the inflammation of the retrocalcaneal bursa, which is located behind the heel bone, also known as the calcaneal bone (hence the name retrocalcaneal). The retrocalcaneal bursa is a thin, slippery, fluid-filled sac that serves as a both a cushion and lubricant between the heel bone and the Achilles tendon. Inflammation of the retrocalcaneal bursa usually results from irritation of the bursa. This irritation may be due to certain activities, an underlying health condition such as arthritis, or an abnormality of the foot, such the development of a boney prominence on the calcaneal bone, called a Haglund's deformity.<br><br>Causes<br>Posterior heel pain can come from one of several causes. When a physician is talking about posterior heel pain, he or she is referring to pain behind the heel, not below it. Pain underneath the heel, on the bottom of the foot, has several causes including Tarsal Tunnel Syndrome. Plantar Fasciitis. Heel Spurs.<br><br>Symptoms<br>In retrocalcaneal bursitis, pain at the back of the heel is the main complaint from patients. Pain may worsen when tip-toeing, running uphill, jumping or hopping. Often, those who are accustomed to wearing high-heeled shoes on a long-term basis may also complain of pain at the back of the heel when switching to flat shoes. This is because when in high-heeled shoes, the calf muscle and the Achilles tendon are in a shortened position. Switching to flat shoes would cause an increased stretch to the calf muscle and Achilles tendon, irritating the Achilles tendon and the retrocalcaneal bursa. Other symptoms may include redness and swelling at the back of the heel.<br><br>Diagnosis<br>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. <br>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.<br><br>Non Surgical Treatment<br>The most important part of treating bursitis is resting your Achilles tendon while the bursa heals. Resting your ankle as much as possible may decrease swelling and keep the bursitis from getting worse. When the pain decreases, begin normal, slow movements. Ice causes blood vessels to constrict (get small) which helps decrease inflammation (swelling, pain, and redness). Put crushed ice in a plastic bag or use a bag of frozen corn or peas. Cover it with a towel. Put this on your heel for 15 to 20 minutes, three to four times each day. Do not sleep on the ice pack because you can get frostbite. After two or three days, you may try using heat to decrease pain and stiffness. Use a hot water bottle, heating pad, whirlpool or warm, moist compress. To make a compress, dip a clean washcloth in warm water. Wring out the extra water and put it on your heel for 15 to 20 minutes, three to four times each day. Your caregiver may tell you to switch between treating your heel with ice packs and heat treatments. Follow the caregiver's directions carefully when doing  feet examined these treatments.<br><br>Surgical Treatment<br>Only if non-surgical attempts at treatment fail, will it make sense to consider surgery. Surgery for retrocalcanel bursitis can include many different procedures. Some of these include removal of the bursa, removing any excess bone at the back of the heel (calcaneal exostectomy), and occasionally detachment and re-attachment of the Achilles tendon. If the foot structure and shape of the heel bone is a primary cause of the bursitis, surgery to re-align the heel bone (calcaneal osteotomy) may be considered. Regardless of which exact surgery is planned, the goal is always to decrease pain and correct the deformity. The idea is to get you back to the activities that you really enjoy. Your foot and ankle surgeon will determine the exact surgical procedure that is most likely to correct the problem in your case. But if you have to have surgery, you can work together to develop a plan that will help assure success.
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Overview<br>Bursitis is the painful inflammation of the bursa, a padlike sac found in areas subject to friction. Bursae cushion the movement between the bones, tendons and muscles near the joints. Bursitis is most often caused by repetitive movement and is known by several common names including weaver's bottom, clergyman's knee, and miner's elbow, depending on the affected individual's occupation and area of injury.<br><br>Causes<br>Posterior heel pain can come from one of several causes. When a physician is talking about posterior heel pain, he or she is referring to pain behind the heel, not below it. Pain underneath the heel, on the bottom of the foot, has several causes including Tarsal Tunnel Syndrome. Plantar Fasciitis. [http://ameblo.jp/cheryllsiemering/entry-12046772462.html Heel Spurs].<br><br>Symptoms<br>Pain or tenderness at the back of the heel around the Achilles region. Increased pain during activities with strong, repetitive calf contractions, walking (uphill), stair climbing, running, jumping. Pain may be worse with rest after activity (that night or the next morning) or at the beginning of the excercise. Pain when wearing shoes and the heel is getting rubbed. Bump forming on the back of the heel. Limping. Stiffness. Decreased range of motion. Redness and warmth (if the bursa gets infected).<br><br>Diagnosis<br>After you have described your foot symptoms, your doctor will want to know more details about your pain, your medical history and lifestyle, including whether your pain is worse at specific times of the day or after specific activities. Any recent injury to the area. Your medical and orthopedic history, especially any history of diabetes, arthritis or injury to your foot or leg. Your age and occupation. Your recreational activities, including sports and exercise programs. The type of shoes you usually wear, how well they fit, and how frequently you buy a new pair.<br><br>Non Surgical Treatment<br>In some cases, physicians may recommend drugs or medications like NSAIDs (non-steroidal anti-inflamatory drugs) to manage pain and inflammation. Alternative medications like cortisone injections are NOT advised for any type of Achilles Tendon injury or condition. This is because there is an increased risk of rupture of the tendon following a cortisone injection. Medical evidence shows that cortisone shots can damage the surrounding tissue, fray the Achilles tendon, and even trigger a rupture. Most side effects are temporary, but skin weakening (atrophy) and lightening of the skin (depigmentation) can be permanent.<br><br>Surgical Treatment<br>Surgery to remove the damaged bursa may be performed in extreme cases. If the bursitis is caused by an infection, then additional treatment is needed. Septic bursitis is caused by the presence of a pus-forming organism, usually staphylococcus aureus. This is confirmed by examining a sample of the fluid in the bursa and requires treatment with antibiotics taken by mouth, injected into a muscle or into a vein (intravenously). The bursa will also need to be drained by needle two or three times over the first week of treatment. When a patient has such a serious infection, there may be underlying causes. There could be undiscovered diabetes, or an inefficient immune system caused by human immunodeficiency virus infection (HIV).

Revisión de 16:16 11 jun 2017

Overview
Bursitis is the painful inflammation of the bursa, a padlike sac found in areas subject to friction. Bursae cushion the movement between the bones, tendons and muscles near the joints. Bursitis is most often caused by repetitive movement and is known by several common names including weaver's bottom, clergyman's knee, and miner's elbow, depending on the affected individual's occupation and area of injury.

Causes
Posterior heel pain can come from one of several causes. When a physician is talking about posterior heel pain, he or she is referring to pain behind the heel, not below it. Pain underneath the heel, on the bottom of the foot, has several causes including Tarsal Tunnel Syndrome. Plantar Fasciitis. Heel Spurs.

Symptoms
Pain or tenderness at the back of the heel around the Achilles region. Increased pain during activities with strong, repetitive calf contractions, walking (uphill), stair climbing, running, jumping. Pain may be worse with rest after activity (that night or the next morning) or at the beginning of the excercise. Pain when wearing shoes and the heel is getting rubbed. Bump forming on the back of the heel. Limping. Stiffness. Decreased range of motion. Redness and warmth (if the bursa gets infected).

Diagnosis
After you have described your foot symptoms, your doctor will want to know more details about your pain, your medical history and lifestyle, including whether your pain is worse at specific times of the day or after specific activities. Any recent injury to the area. Your medical and orthopedic history, especially any history of diabetes, arthritis or injury to your foot or leg. Your age and occupation. Your recreational activities, including sports and exercise programs. The type of shoes you usually wear, how well they fit, and how frequently you buy a new pair.

Non Surgical Treatment
In some cases, physicians may recommend drugs or medications like NSAIDs (non-steroidal anti-inflamatory drugs) to manage pain and inflammation. Alternative medications like cortisone injections are NOT advised for any type of Achilles Tendon injury or condition. This is because there is an increased risk of rupture of the tendon following a cortisone injection. Medical evidence shows that cortisone shots can damage the surrounding tissue, fray the Achilles tendon, and even trigger a rupture. Most side effects are temporary, but skin weakening (atrophy) and lightening of the skin (depigmentation) can be permanent.

Surgical Treatment
Surgery to remove the damaged bursa may be performed in extreme cases. If the bursitis is caused by an infection, then additional treatment is needed. Septic bursitis is caused by the presence of a pus-forming organism, usually staphylococcus aureus. This is confirmed by examining a sample of the fluid in the bursa and requires treatment with antibiotics taken by mouth, injected into a muscle or into a vein (intravenously). The bursa will also need to be drained by needle two or three times over the first week of treatment. When a patient has such a serious infection, there may be underlying causes. There could be undiscovered diabetes, or an inefficient immune system caused by human immunodeficiency virus infection (HIV).

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