Bursitis Of The Foot

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

Overusing your calves, ankles and heels during inappropriate or excessive training or doing repetitive motions for prolonged periods of time can contribute to the development of the this painful ankle Achilles and retrocalcaneal bursitis aliment. Bursitis in this part of the body often occurs in professional or recreational athletes. Walking, running and jumping can do some damage. (I loved to skip rope before I suffered my severe hip bursitis.). Injury. This condition may also develop following trauma such as a direct, hard hit to your heel. Footwear. Poorly fitting shoes that are too tight, too large or have heels can all cause excessive pressure or friction over the bursa in the heel. Infection. Medical problems, such as rheumatoid arthritis or gout, sometimes lead to bursitis. It is not unusual to have Achilles bursitis and tendonitis (inflamed tendon) at the same time. Ankle bursitis is often a genetic condition where you simply inherited a foot type, for example a heel bone with a prominence, high arch or tight Achilles tendon, that is more prone to the mechanical irritation that leads to the bursitis. Muscle weakness, joint stiffness and poor flexibility (particularly of the calf muscles) are certainly contributing factors too.

Symptoms

Bursitis usually causes a dull pain, tenderness, and stiffness near the affected bursa. The bursa may swell and make the skin around it red and warm to the touch. Bursitis is most common in the shoulder camera.gif, elbow camera.gif, hip camera.gif, and knee camera.gif. Bursitis may also occur near the Achilles tendon or in the foot. Symptoms of bursitis may be like those of tendinopathy. Both occur in the tissues in and around the joints. Check with your doctor if your pain is severe, if the sore area becomes very hot or red, or if you have a fever.

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

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. Though rare, particularly challenging cases of retrocalcaneal bursitis might warrant a bursectomy, in which the troublesome bursa is removed from the back of the ankle. Surgery can be effective, but operating on this boney area can cause complications, such as trouble with skin healing at the incision site. In addition to removing the bursa, a doctor may use the surgery to treat another condition associated with the retrocalcaneal bursitis. For example, a surgeon may remove a sliver of bone from the back of the heel to alter foot mechanics and reduce future friction. Any bone spurs located where the Achilles attaches to the heel may also be removed. Regardless of the conservative treatment that is provided, it is important to wait until all pain and swelling around the back of the heel is gone before resuming activities. This may take several weeks. Once symptoms are gone, a patient may make a gradual return to his or her activity level before their bursitis symptoms began. Returning to activities that cause friction or stress on the bursa before it is healed will likely cause bursitis symptoms to flare up again.

Prevention

It isn't always possible to avoid the sudden blow, bump, or fall that may produce bursitis. But you can protect your body with measures similar to those that protect you from other kinds of overuse injuries, such as tendinitis. Keep yourself in good shape. Strengthening and flexibility exercises tone muscles that support joints and help increase joint mobility. Don?t push yourself too hard (or too long). If you?re engaged in physical labor, pace yourself and take frequent breaks. If you?re beginning a new exercise program or a new sport, work up gradually to higher levels of fitness. And anytime you?re in pain, stop. Work on technique. Make sure your technique is correct if you play tennis, golf, or any sport that may strain your shoulder. Watch out for ?elbow-itis.? If you habitually lean on your elbow at your work desk, this may be a sign that your chair is uncomfortable or the wrong height. Try to arrange your work space so that you don?t have to lean on your elbow to read, write, or view your computer screen. Take knee precautions. If you have a task that calls for lots of kneeling (for example, refinishing or waxing a floor), cushion your knees, change position frequently, and take breaks. Wear the right shoes. High-heeled or ill-fitting shoes cause bunions, and tight shoes can also cause bursitis in the heel. Problems in the feet can also affect the hips. In particular, the tendons and bursae in the hips can be put under excessive strain by worn-down heels. Buy shoes that fit and keep them in good repair. Never wear a shoe that?s too short or narrow. Women should save their high heels for special occasions only. Avoid staying in only one position for too long. Get up and walk around for a while or change positions frequently.

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