Treatment Of Bursitis Of The Foot

Overview

Retrocalcaneal Bursitis. This bursa is located at the back of the heel. Bursitis in this area is often associated with conditions such as ankylosing spondylitis or rheumatoid arthritis. It can occur in healthy individuals who wear improperly fitted shoes. Symptoms include painful swelling that develops at the back of the heel. Calcaneal Bursitis. This bursa is located at the sole or bottom of the heel. Inflammation usually produces pain in the heel when standing. Causes include heel spurs, excess weight, injury, and wearing improperly fitted shoes.

Causes

Bursitis, tendinitis, and other soft tissue rheumatic syndromes typically result from one or more factors. These include: Play or work activities that cause overuse or injury to the joint areas Incorrect posture Stress on the soft tissues from an abnormal or poorly positioned joint or bone (such as leg length differences or arthritis in a joint) Other diseases or conditions (rheumatoid arthritis, gout, psoriasis, thyroid disease, or an unusual drug reaction) Infection.

Symptoms

Retrocalcaneal bursitis is very similar to Achilles bursitis as the bursae are very close in proximity and symptoms are almost identical however retrocalcaneal bursitis is a lot more common. The symptoms of bursitis vary depending on whether the bursitis is the result of injury or an underlying health condition or from infection. From normal overuse and injury the pain is normally a constant dull ache or burning pain at the back of the heel that is aggravated by any touch, pressure like tight shoes or movement of the joint. There will normally be notable swelling around the back of the heel. In other cases where the bursa lies deep under the skin in the hip or shoulder, swelling might not be visible. Movement of the ankle and foot will be stiff, especially in the mornings and after any activity involving the elbow. All of these symptoms are experienced with septic bursitis with the addition of a high temperature of 38?C or over and feverish chills. The skin around the affected joint will also appear to be red and will feel incredibly warm to the touch. In cases of septic bursitis it is important that you seek medical attention. With injury induced bursitis if symptoms are still persisting after 2 weeks then report to your GP.

Diagnosis

Carrying out a diagnosis for bursitis is fairly straightforward. The doctor will examine the affected area and ask the patient some questions about his/her recent activities. If the patient has a high temperature the physician may take a small sample of fluid from a bursa near the affected body part. The sample will be tested for bacteria, and perhaps also crystals. If the patient does not get better after treatment the doctor may carry out further tests so that he/she can eliminate the possibility that the symptoms might not be due to something else. These may include an x-ray, to make sure no bones are broken or fractured. Blood tests, to check for rheumatoid arthritis. A CT scan or MRI scan to see if there is a torn tendon.

Non Surgical Treatment

Relieving the symptoms of bursitis initially focuses on taking the pressure off the bursa. This can be done with proper cushioning, inserts, or footwear but may require surgery if it is a bone formation problem (i.e. Huglund's Deformity). If your bursitis is caused by an infection (septic bursitis), the doctor will probably drain the bursa sac with a needle and prescribe antibiotics to treat the infection.

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.

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