Bursitis Foot Pain Signs Or Symptoms

posted on 22 Aug 2015 23:39 by humorousalmanac6
Overview

Retrocalcaneal Bursitis is an inflammation of the protective sack between the heel bone and the Achilles tendon. It is the inflamed bursa that produces the redness and swelling associated with Haglund's deformity.

Causes

Bursitis occurs when the synovial lining becomes thickened and produces excessive fluid, leading to localized swelling and pain. It most commonly affects the subacromial, olecranon, trochanteric, prepatellar, and infrapatellar bursae. Symptoms of bursitis may include localized tenderness, pain, edema, erythema, or reduced movement. Pain is aggravated by movement of the specific joint, tendon, or both.

Symptoms

Pain at the back of the heel, especially with jumping, hopping, tip-toeing, walking or running uphill or on soft surfaces. If tendonitis is also present, the pain can radiate away from the bursa. Direct pressure on the bursa will exacerbate the pain and should be avoided if possible. Tenderness and swelling which might make it difficult to wear certain shoes on the feet. As the bursa becomes more inflamed you will experience swelling and warmth. In severe cases, the bursa will appear as a bump, called a "pump bump", and is usually red, and extremely tender. Swelling can cause difficulties moving as the range of motion in the ankle can be affected. Limping due to the pain may occur. If you press on both sides of the inflamed heel, there may be a firm spongy feeling. Weakness in the tendons and muscles surrounding the bursa can develop as the pain worsens and the inflammation in the area spreads. Possibly a fever if you are suffering from septic bursitis (You will need to see a doctor for medication to get rid of the infection). Pain at the back of the heel makes it difficult to continue wearing shoes, especially high heels with straps or shoes that don't fit properly.

Diagnosis

If heel pain has not responded to home treatment, X-rays may be ordered. These images can show deformities of the heel bone and bone spurs that have developed at the attachment of the Achilles. If there is swelling and/or pain that is slightly higher and within the Achilles tendon itself, an MRI may be ordered to determine if the tendon is simply inflamed or if there is a chronic tear on the tendon. Aspiration and lab tests. If a septic bursitis is highly suspected, a doctor may perform an aspiration, removing fluid from the bursa with a needle and syringe. In addition to relieving pressure and making the patient more comfortable, it provides a fluid sample that can be tested for infection.

Non Surgical Treatment

Treatment consists of anti-inflammatory therapy with the use of ice, short term non steroidal therapy including ibuprofen and naproxen and selective use of cortisone injections. Cortisone injections have been shown to be a highly effective anti-inflammatory measure for relieving foot and ankle pain. Care must always be taken by the physician to insure that the injection is administered into the bursal sac and not the Achilles tendon which can cause tendon injury. Treatment also consists of the use of heel lifts or the temporary use of a shoe with a low heel. The heel lift decreases the mechanical load on the Achilles tendon. Gentle stretching of the Achilles tendon, the possible use of a splint that is worn at night as well as physical therapy as directed by your physician can be employed. Temporary activity limitations for fitness must be incorporated into the treatment plan. Any weight bearing activity for exercise that actively lifts your heel off of the ground including running, walking stair stepper will interfere with effective conservative care. Low impact activity including biking and pool tend to be safe exercises during your recovery.

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.