Bursitis Of The Feet Pain In Heel

Overview
Bursitis is the inflammation of a bursa. Retrocalcaneal bursitis is in inflammation of the bursa located between the calcaneus and the anterior surface of the Achilles tendon.There are two bursae located just superior to the insertion of the Achilles (calcaneal) tendon. Anterior or deep to the tendon is the retrocalcaneal (subtendinous) bursa, which is located between the Achilles tendon and the calcaneus. Posterior or superficial to the Achilles tendon is the subcutaneous calcaneal bursa, also called the Achilles bursa. This bursa is located between the skin and posterior aspect of the distal Achilles tendon.Inflammation of either or both of these bursa can cause pain at the posterior heel and ankle region. It is also known as Achille tendon bursitis. It can often be mistaken for Achilles tendonitis or can also occur in conjunction with Achilles tendonitis.

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
What are the symptoms of heel bursitis? pain, swelling, tenderness, redness, and/or warmth at either the bottom of the heel or top of the heel, depending on the degree of swelling, pain may be a dull ache or substantial enough to cause limping, running, jumping, and walking activities may exacerbate pain, wearing poorly fitting, tight, or high-heeled shoes may exacerbate pain.

Diagnosis
On physical examination, patients have tenderness at the site of the inflamed bursa. If the bursa is superficial, physical examination findings are significant for localized tenderness, warmth, edema, and erythema of the skin. Reduced active range of motion with preserved passive range of motion is suggestive of bursitis, but the differential diagnosis includes tendinitis and muscle injury. A decrease in both active and passive range of motion is more suggestive of other musculoskeletal disorders. In patients with chronic bursitis, the affected limb may show disuse atrophy and weakness. Tendons may also be weakened and tender.

Non Surgical Treatment
Specific treatment for bursitis will be determined by your doctor based on your age, overall health, and medical history. Extent of the condition. Your tolerance for specific medications, procedures, or therapies. Expectations for the course of the condition. Your opinion or preference. The treatment of any bursitis depends on whether or not it involves infection. Aseptic bursitis. A noninfectious condition caused by inflammation resulting from local soft-tissue trauma or strain injury. Treatment may include R.I.C.E. Rest, Ice, Compression, and Elevation. Anti-inflammatory and pain medications, such as ibuprofen or aspirin. Aspiration of the bursa fluid for evaluation in the laboratory. Injection of cortisone into the affected area. Rest. Splints.

Surgical Treatment
Bursectomy is a surgical procedure used to remove an inflamed or infected bursa, which is a fluid-filled sac that reduces friction between tissues of the body. Because retrocalcaneal bursitis can cause chronic inflammation, pain and discomfort, bursectomy may be used as a treatment for the condition when it is persistent and cannot be relived with other treatments. During this procedure, a surgeon makes small incisions so that a camera may be inserted into the joint. This camera is called an arthroscope. Another small incision is made so that surgical instruments can be inserted to remove the inflamed bursa.

Prevention
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.