Bursitis Of The Feet Bursa Sac

Overview
Heel bursitis is specifically the inflammation of the retrocalcaneal bursa, located at the back of the heel, under the Achilles tendon. There are a handful of factors that put you at risk for developing heel bursitis. Long distance runners are prone to heel bursitis, due to repeated stress and pounding upon the heel joint. Engaging in activities such as running, bicycling, walking, jumping, and stair climbing for extended periods of time can overwork the heel joints and start to irritate the bursae. Suddenly changing to a high-intensity workout regime puts a lot of stress on the heel, making it vulnerable to injury. Hard blows/bumps to the heel can immediately damage the bursae, leading to swelling and inflammation. Training at high intensities without stretching and warming up can also contribute to the development of heel bursitis. Even improper footwear can be a big factor. Some other conditions can put you at risk as well, such as: tarsal tunnel syndrome, rheumatoid arthritis, plantar fasciitis, muscle weakness, joint stiffness, and heel spurs. It is very important to get a professional diagnosis if you are having heel pain because heel bursitis is often confused for Achilles tendonitis, and the proper treatments are very different. The pain could also be plantar fasciitis or general heel pain syndrome.

Causes
The most common causative organism is Staphylococcus aureus (80% of cases), followed by streptococci. However, many other organisms have been implicated in septic bursitis, including mycobacteria (both tuberculous and nontuberculous strains), fungi (Candida), and algae (Prototheca wickerhamii). Factors predisposing to infection include diabetes mellitus, steroid therapy, uremia, alcoholism, skin disease, and trauma. A history of noninfectious inflammation of the bursa also increases the risk of septic bursitis.

Symptoms
The signs and symptoms of heel bursitis can include heel pain wearing particular footwear, Pain or discomfort in the heel when walking, jogging or running, Swelling or inflammation in the heel.

Diagnosis
Your doctor will take a history to find out if you have the symptoms of retrocalcaneal bursitis. By examining your ankle, he or she can generally tell the location of the pain. The physician will look for tenderness and redness in the back of the heel. The pain may be worse when the doctor bends the ankle upward (dorsiflex), as this may tighten the achilles tendon over the inflamed bursa. Alternatively, the pain may be worse with toe rise, as this puts stress on the attachment of the achilles tendon to the heel bone. Imaging studies such as X-ray and MRI are not usually necessary at first. If initial treatment fails to improve the symptoms, these studies may be obtained. MRI may show inflammation.

Non Surgical Treatment
Podiatric Care may include using anti-inflammatory oral medications or an injection of medication and local anesthetic to reduce the swelling in the bursa. An injection may be used for both diagnosis and for treatment. When you go to your doctor, x-rays are usually required to evaluate the structure of your foot and ankle to ensure no other problems exist in this area. They may advise you on different shoewear or prescribe a custom made orthotic to try and control the foot structure especially if you have excessive pronation. Sometimes patients are sent to Physical Therapy for treatment as well. To aid in relief of pressure points, some simple padding techniques can be utilized. Most all patients respond to these conservative measures once the area of irritation is removed.

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.