How To Treat Bursitis Of The Foot

Overview

Swelling and inflammation near a joint may be a sign of bursitis, a condition that involves buildup of liquid and inflammation in a bursa sac that cushions a joint. This condition has earned some interesting names over the years: housemaid?s knee, student?s elbow, and tailor?s bottom, to name a few. Simply put, bursitis is the inflammation of a bursa and buildup of fluid in the bursa sac. A bursa is a thin, slippery sac found around a joint that serves to reduce friction between bone and surrounding soft tissue, such as skin, muscles, ligaments and tendons. A bursa sac is made up of a synovial membrane, or synovium, that produces and contains synovial fluid. Excessive friction, a trauma, or other condition can irritate the synovium and cause it to become inflamed. The inflamed synovium will thicken and produce excess synovial fluid, and can cause symptoms such as localized swelling, skin redness and warmth, tenderness and pain. Of the approximately 160 bursae in the body, only a handful of them usually cause bursitis. These usual suspects are found in the knee, shoulder, elbow, and hip. Less frequently, bursitis may also occur in the heel, wrist, buttocks and big toe.

Causes

There are several factors which can lead to a person developing retrocalcaneal bursitis. In athletes, especially runners, overtraining, sudden excessive increase in running mileage may lead to retrocalcaneal bursitis. Tight or ill-fitting shoes can be another causative factor as they can produce excessive pressure at the back of the heel due to restrictive heel counter. A person with an excessively prominent posterosuperior aspect of the heel bone (Haglund deformity) may also have a higher predisposition to retrocalcaneal bursitis. In such individuals, pain would be reproduced when the ankle goes into dorsiflexion.

Symptoms

Common signs and symptoms associated with infracalcaneal bursitis include redness under the heel. Pain and swelling under the heel. Pain or ache in the middle part of the underside of the heel. Heel pain or discomfort that increases with prolonged weight-bearing activities.

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

Non-operative treatment is the standard approach to treating posterior heel pain. It is highly desirable to treat this condition non-operatively, as operative treatment is often associated with a prolonged recovery. Traditional non-operative treatment includes the following. Heel Lift or the Use of a Shoe with a Moderate Heel. Walking barefoot or in a flat-soled shoe increases the tension on the insertion of the Achilles tendon. Using a heel lift or a shoe with a moderate heel can help reduce the stress on the tendon and decrease the irritation caused by this condition.

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

Protect that part of the body that may be most vulnerable, If you have to kneel a lot, get some knee pads. Elbow braces can protect tennis and golf players. If you are an athlete or avid walker, invest in some good walking or running shoes. When doing repetitive tasks have breaks. Apart from taking regular breaks, try varying your movements so that you are using different parts of your body. Warm up before exercise. Before any type of vigorous exercise you should warm up for at least 5 to 10 minutes. The warm up could include walking at a good speed, slow jogging, or a cycling machine. Strong muscles add extra protection to the area. If you strengthen the muscles in the area where you had bursitis (after you are better), especially the area around the joint, you will have extra protection from injury. Make sure you do this well after your bursitis has gone completely.

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