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Overview<br>Bursae (two or more bursa) are small, fluid-filled sacs that cushion the bones, tendons and muscles surrounding your joints.  They contain a lubricating fluid that reduces friction, allowing tissues in the body to glide past each other smoothly. Imagine the bursa as a protective layer that helps keep a tendon or muscle from fraying or getting aggravated as it eases over a bone or around a corner. Bursitis is a condition that occurs when a bursa becomes inflamed: irritated, red and filled with more fluid than normal.<br><br>Causes<br>Wearing poorly fitting or constrictive footwear can cause the heel to become irritated and inflamed. Shoes that dig into the back of the heel are the primary cause of retroachilles bursitis. Foot or ankle deformity. A foot or ankle deformity can make it more likely to develop retrocalcaneal bursitis. For example, some people can have an abnormal, prominent shape of the top of their heel, known as a Haglund's deformity. This condition increases the chances of irritating the bursa. A trauma to the affected heel, such as inadvertently striking the back of the heel against a hard object, can cause the bursa to fill with fluid, which in turn can irritate and inflame the bursa's synovial membrane. Even though the body usually reabsorbs the fluid, the membrane may stay inflamed, causing bursitis symptoms.<br><br>Symptoms<br>A dull ache under the heel when not weight bearing. Sometimes severe pain when walking. Pain can increase after resting (sleeping or sitting) then standing and placing pressure on the area again. Throbbing under the heel. Swelling may be identified as a discernible lump under the heel. This is the swollen calcaneal bursa itself. Tingling under the heel as swelling affect the plantar nerves. Pains shooting into the foot or up the leg.<br><br>Diagnosis<br>Before making a diagnosis of retrocalcaneal bursitis, a doctor must rule out other possible problems, such as arthritis, a fracture or tumor. A doctor also will try to determine if the Achilles tendon itself is a source of pain. To make a diagnosis, a doctor will use some or all of the diagnostic tools below Patient interview. A doctor will ask a patient about medical history, and to describe the onset of his or her symptoms, the pattern of pain and swelling, and how symptoms affect lifestyle. For example, doctors may ask patients what [https://siobhankallbrier.wordpress.com/2014/12/30/caring-for-bunions-the-best-methods types of shoes] they wear and what they do for exercise. A patient's reported symptoms are important to diagnosis and treatment. The doctor will also ask what home treatments have helped the condition. Physical exam. A doctor will examine the patient's foot, noting swelling, tenderness and pain points, and range of motion. The doctor also may ask the patient to point and flex the feet and stand on his or her toes.<br><br>Non Surgical Treatment<br>Treatment is primarily comprised of relief from the painful activity (running). It is important that shoes do not pinch the heel. If satisfactory progress is not made during the rehabilitation, medical treatment can be considered in the form of rheumatic medicine (NSAID) or injection of corticosteroid in the bursa. Injections should be performed under ultrasound guidance to ensure optimal effect and reduce the risk of injecting into the Achilles itself. If progress is not made neither through rehabilitation nor medicinal treatment, surgical treatment can be attempted.<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>Is bursitis in your heel or ankle causing pain and discomfort that is affecting your ability to participate in sports, exercise or even possibly beginning to take a toll of your work and life in general? Heel bursitis can be extremely painful and debilitating, what more the heel is such a hard area of the body to properly rest as we are constantly on our feet. This may cause extreme emotional stress on even the most strongly minded individual.<br><br>Causes<br>The calcaneal bursa can become inflamed in patients with [http://plaza.rakuten.co.jp/yuonnepeinado/diary/201507110001 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.<br><br>Symptoms<br>You might have Retrocalcaneal Bursitis if you notice any of the following symptoms. You have pain or tenderness at the back of the heel where the Achille's tendon attaches. Have swelling near the attachment of the tendon to the heel bone. You have noticed a slowly growing bump on the back of the heel. The back of the heel turns red after getting rubbed in shoes. The back of the heel hurts worse when you run, walk up hill or wear high heels.<br><br>Diagnosis<br>The diagnosis is based on the symptoms and an examination. For anterior Achilles tendon bursitis, doctors use x-rays to rule out a fracture of the heel bone or damage to the heel bone caused by rheumatoid arthritis or other inflammatory arthritis.<br><br>Non Surgical Treatment<br>There are a variety of treatments for bursitis of the heel. Bursitis on the bottom of your heel (which is called infracalcaneal bursitis) is common in heels with thinning fat pads. Gel heel cushions or custom made orthotics (that have a horse-shoe cut and extra foam in the heel) can be lifesavers in reducing the pain. For bursitis of the posterior heel (retrocalcaneal bursitis), try to avoid going barefoot and to reduce the stress on the Achilles tendon by not over flexing your heel, the tighter your Achilles becomes, the more you compress the bursa sacs of the posterior heel. Heel lifts can help this, or wearing shoes with elevated heels (note that this method is not sanctioning high heels, as high heels can provide little comfort or support and usually are tight in the areas where your bursitis is most inflamed). Products such as AirHeel made by Aircast can help massage the bottom and back of the heel, helping to decrease pain.<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).

Última revisión de 12:07 12 jun 2017

Overview
Is bursitis in your heel or ankle causing pain and discomfort that is affecting your ability to participate in sports, exercise or even possibly beginning to take a toll of your work and life in general? Heel bursitis can be extremely painful and debilitating, what more the heel is such a hard area of the body to properly rest as we are constantly on our feet. This may cause extreme emotional stress on even the most strongly minded individual.

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
You might have Retrocalcaneal Bursitis if you notice any of the following symptoms. You have pain or tenderness at the back of the heel where the Achille's tendon attaches. Have swelling near the attachment of the tendon to the heel bone. You have noticed a slowly growing bump on the back of the heel. The back of the heel turns red after getting rubbed in shoes. The back of the heel hurts worse when you run, walk up hill or wear high heels.

Diagnosis
The diagnosis is based on the symptoms and an examination. For anterior Achilles tendon bursitis, doctors use x-rays to rule out a fracture of the heel bone or damage to the heel bone caused by rheumatoid arthritis or other inflammatory arthritis.

Non Surgical Treatment
There are a variety of treatments for bursitis of the heel. Bursitis on the bottom of your heel (which is called infracalcaneal bursitis) is common in heels with thinning fat pads. Gel heel cushions or custom made orthotics (that have a horse-shoe cut and extra foam in the heel) can be lifesavers in reducing the pain. For bursitis of the posterior heel (retrocalcaneal bursitis), try to avoid going barefoot and to reduce the stress on the Achilles tendon by not over flexing your heel, the tighter your Achilles becomes, the more you compress the bursa sacs of the posterior heel. Heel lifts can help this, or wearing shoes with elevated heels (note that this method is not sanctioning high heels, as high heels can provide little comfort or support and usually are tight in the areas where your bursitis is most inflamed). Products such as AirHeel made by Aircast can help massage the bottom and back of the heel, helping to decrease pain.

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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