What Causes Bursitis Of The Feet?

Overview

Retrocalcaneal bursitis is closely related to Haglund?s Deformity (or ?pump bumps?). If you have a bony enlargement on the back of the heel that rubs the Achilles tendon, it can cause the formation of a bursa (small fluid filled sack). It usually happens in athletes as shoes rub against the heel. The bursa can aggravated by the stitching of a heel counter in the shoe as well. It can make wearing shoes and exercising difficult. Another term used for this condition is ?pump bump? because it can frequently occur with wearing high heels as well. ?Retro-" means behind and ?calcaneus? means heel bone. So this is precisely where the bursitis (inflammation of the bursa) develops. Once it begins and you develop bursitis between the heel bone and the Achilles tendon, it can become even more painful. When most people first notice retrocalcaneal bursitis, it is because the skin, bursa and other soft tissues at the back of the heel gets irritated as the knot of bone rubs against the heel counter in shoes. The back of the shoes create friction and pressure that aggravate the bony enlargement and pinches the bursa while you walk.

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

Pain at the back of the heel at the attachment site of the Achilles tendon when running. Pain on palpation of the back of the heel or bottom of heel. Pain when standing on tiptoes. Swelling and redness at the back and bottom of the heel.

Diagnosis

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 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.

Non Surgical Treatment

Conservative treatment of bursitis is usually effective. The application of heat, rest, and immobilization of the affected joint area is the first step. A sling can be used for a shoulder injury, a cane is helpful for hip problems. The patient can take nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin, ibuprofin, and naproxen. They can be obtained without a prescription and relieve the pain and inflammation. Once the pain decreases, exercises of the affected area can begin. If the nearby muscles have become weak because of the disease or prolonged immobility, then exercises to build strength and improve movement are best. A doctor or physical therapist can prescribe an effective regimen. If the bursitis is related to an inflammatory condition like arthritis or gout, then management of that disease is needed to control the bursitis. When bursitis does not respond to conservative treatment, an injection into the joint of a long-acting corticosteroid preparation, like prednisone, can bring immediate and lasting relief. A corticosteroid is a hormonal substance that is the most effective drug for reducing inflammation. The drug is mixed with a local anesthetic and works on the joint within five minutes. Usually one injection is all that is needed.

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.

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