Bursitis Foot Pain Warning Signs

Overview

A bursa is a fluid-containing sac that is present at many areas of pressure on the body. Its job is to protect these areas of pressure by being a shock absorber. A bursitis is an abnormal inflammation of the bursa sac caused by abnormal excessive pressure, stress and/ or strain over the area it is protecting. On the heel bone, there are two bursa sacs: one on the bottom and the other on the back. Specifically on the bottom of the heel, it is known as an Inferior (bottom) Calcaneal (heel) Bursa. On the back of the heel, it is called the Retro (back) Calcaneal Bursa. When either of these bursas become abnormally stressed, strained, or swollen, the result is bursitis of the heel. It is this bursitis that is the reason for pain in the heel upon arising (Poststatic Dyskinesia) in the morning or after resting for a while. You can either develop these bursitises with or without the presence of heel spur (explanation to follow). As stated before, Morton?s Toe can cause this by causing over pronation in the foot.

Causes

Posterior heel pain can come from one of several causes. When a physician is talking about posterior heel pain, he or she is referring to pain behind the heel, not below it. Pain underneath the heel, on the bottom of the foot, has several causes including Tarsal Tunnel Syndrome. Plantar Fasciitis. Heel Spurs.

Symptoms

Bursitis involving the heel causes pain in the middle of the undersurface of the heel that worsens with prolonged standing and pain at the back of the heel that worsens if you bend your foot up or down.

Diagnosis

A good clinical practise includes evaluation of the tendon, bursa and calcaneum by, careful history, inspection of the region for bony prominence and local swelling as well as palpation of the area of maximal tenderness. Biomechanical abnormalities, joint stiffness and proximal soft tissue tightening can exacerbate an anatomical predisposition to retrocalcaneal bursitis, they warrant correction when present.

Non Surgical Treatment

The initial treatment for retrocalcaneal bursitis is to avoid activities that cause pain and take non-steroidal anti-inflammatory medications (for example, ibruprofen). Your doctor may recommend icing the heel several times a day and may prescribe physical therapy to improve flexibility and strength around the ankle. Physical therapy serves two functions, it can help the bursitis improve and it can help prevent future recurrences.

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

Once your pain and inflammation is gone, you can prevent retrocalcaneal bursitis deformity by wearing the best shoes for your foot type. You should high-heels and pumps if possible. Wear orthotics (custom arch supports) or over-the-counter orthotic devices. Perform frequent Achilles tendon stretching exercises to prevent it from becoming tight agian. Avoiding running uphill when training. Try to run on softer surfaces and avoid concrete.

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  • #1

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