Bursitis On The Foot And Ankle

Overview

Retrocalcaneal bursitis and Achilles bursitis are the most widely spread types of ankle / heel bursitis out there. However, there are several bursa lubrication fluid sacs behind the heel bone protecting this area that may become irritated, inflammed and painful.

Causes

The retrocalcaneal bursa can become inflamed as the result of another condition, such as damage to the Achilles tendon, osteoarthritis, rheumatoid arthritis, gout, and pseudogout. In these instances, the treatment for bursitis must accompany treatment for the underlying condition. Septic retrocalcaneal bursitis, which is caused by an infection, is uncommon. Infection can reach the bursa through a cut, puncture, a blister, or even an insect bite. It is possible to have septic bursitis without an obvious opening. In these cases the superficial wound may have healed quickly, but still allowed bacteria into the bursa.

Symptoms

Your feet are extremely resilient and are designed to stand up to the pressures of day-to-day living. In some cases, though, foot structures may break down when subjected to chronic stress associated with prolonged periods of weight-bearing activity on concrete, asphalt, or other hard surfaces (especially when your footwear does not allow for appropriate weight distribution). Foot problems, including infracalcaneal bursitis, are often exacerbated by poorly designed footwear, and pressure, impact, and shear forces can damage your feet over time. Bursal sacs are intended to minimize this damage, but sometimes the bursa itself becomes inflamed.

Diagnosis

Gram stain. A lab test called a Gram stain is used to determine if certain troublesome bacteria are present. Not all bacteria can be identified with a Gram stain, however, so even if the test comes back negative, septic bursitis cannot be completely ruled out. White blood cell count. An elevated number of white blood cells in the bursa's synovial fluid indicates an infection. Glucose levels test. Glucose levels that are significantly lower than normal may indicate infection.

Non Surgical Treatment

Cold compresses can help reduce the initial swelling and pain in acute (short-term but severe) soft tissue conditions. Cold therapy is usually most effective during the first 48 hours after swelling begins. Guidelines for cold therapy include. Use a cold gel pack, a bag filled with ice cubes, or even a bag of frozen vegetables. Wrap the pack in a towel if the cold temperature is too painful. Place the cold pack over the area for 20 minutes, three to four times a day. Rub an ice cube over smaller painful areas for a short time. After 48 hours, or for chronic (long-term) pain, dry or moist heat may be more helpful than cold compresses. Follow these guidelines. Use a hot pack, a heating pad, or a damp towel heated in the microwave (make sure it's not too hot or it may burn your skin). Place a hot pack over the painful area for 15-20 minutes, three to four times a day. Never use analgesic creams or rubs with heat packs because the combination could severely burn your skin. Take a warm shower or bath.

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

It isn't always possible to avoid the sudden blow, bump, or fall that may produce bursitis. But you can protect your body with measures similar to those that protect you from other kinds of overuse injuries, such as tendinitis. Keep yourself in good shape. Strengthening and flexibility exercises tone muscles that support joints and help increase joint mobility. Don?t push yourself too hard (or too long). If you?re engaged in physical labor, pace yourself and take frequent breaks. If you?re beginning a new exercise program or a new sport, work up gradually to higher levels of fitness. And anytime you?re in pain, stop. Work on technique. Make sure your technique is correct if you play tennis, golf, or any sport that may strain your shoulder. Watch out for ?elbow-itis.? If you habitually lean on your elbow at your work desk, this may be a sign that your chair is uncomfortable or the wrong height. Try to arrange your work space so that you don?t have to lean on your elbow to read, write, or view your computer screen. Take knee precautions. If you have a task that calls for lots of kneeling (for example, refinishing or waxing a floor), cushion your knees, change position frequently, and take breaks. Wear the right shoes. High-heeled or ill-fitting shoes cause bunions, and tight shoes can also cause bursitis in the heel. Problems in the feet can also affect the hips. In particular, the tendons and bursae in the hips can be put under excessive strain by worn-down heels. Buy shoes that fit and keep them in good repair. Never wear a shoe that?s too short or narrow. Women should save their high heels for special occasions only. Avoid staying in only one position for too long. Get up and walk around for a while or change positions frequently.

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