Ivelisse Harnar

Foot Pain Heel And Side Of Foot

Bursitis Of The Foot Anatomy

Overview

Heel bursitis is also known as retrocalcaneal bursitis. The heel bone is called calcaneus, and the bursa associated with the heel bone is located in the area between the Achilles tendon and calf muscles. When this particular bursa gets aggravated due to constant pressure in the ankle, the posterior end of the heel or the area behind the heel gets inflamed and hence the result is retrocalcaneal bursitis. Strain to the ankles could be caused due to various reasons like extraneous jogging, skipping, or such physical activities that increase the pressure on the ankles.

Causes

The following are some of the more common causes for heel bursitis. Overuse (common in runners and athletes). Running with the wrong footwear. A sudden impact to the foot. Repetitive stress. Underlying inflammatory condition (such as osteoarthritis).

Symptoms

The signs and symptoms of heel bursitis can include heel pain wearing particular footwear, Pain or discomfort in the heel when walking, jogging or running, Swelling or inflammation in the heel.

Diagnosis

Obtaining a detailed history from the patient is important in diagnosing calcaneal bursitis. The following complaints (which the physician should ask about during the subjective examination) are commonly reported by patients.

Other inquiries that the physician should make include the following. The clinician should ask about the patient's customary footwear (whether, for example, it includes high-heeled shoes or tight-fitting athletic shoes). The patient should be asked specifically about any recent change in footwear, such as whether he/she is wearing new athletic shoes or whether the patient has made a transition from flat shoes to high heels or vice versa. Individuals who have been accustomed to wearing high-heeled shoes on a long-term basis may find that switching to flat shoes causes increased stretch and irritation of the Achilles tendon and the associated bursae. The specifics of a patient's activity level should be ascertained, including how far the patient runs and, in particular, whether the individual is running with greater intensity than before or has increased the distance being run. The history of any known or suspected underlying rheumatologic conditions, such as gout, rheumatoid arthritis, or seronegative spondyloarthropathies, should be obtained.

Non Surgical Treatment

Caregivers may give you special shoe inserts with a cutout around the tender area. You may also be told to wear shoes with a reinforced heel counter. This will give better heel control. You may need other shoe inserts (wedges) to raise your heel so it does not press against the back of the shoe. You may also wear shoes that are open in the back, such as sandals that have no strap across the heel. You may use ibuprofen (eye-bu-PROH-fen) and acetaminophen (a-seet-a-MIN-oh-fen) medicine for your pain. These may be bought over-the-counter at drug or grocery stores. Do not take ibuprofen if you are allergic to aspirin. You may be given shots of medicine called steroids (STER-oids) to decrease inflammation. Caregivers may add local anesthesia (an-es-THEE-zah) to the steroids. This medicine helps decrease bursitis pain. Because these shots decrease swelling and pain, you may feel like your ankle is healed and that you can return to heavy exercise. It is important to not exercise until your caregiver says it is OK. You could make the bursitis worse if you exercise too soon. You may need surgery to remove the bursa or part of your ankle bone. Surgery is usually not necessary unless the bursitis is very bad and does not heal with other treatments. Your caregiver may want you to go to physical (FIZ-i-kal) therapy (THER-ah-pee). Physical therapists may use ultrasound to increase blood flow to the injured area. Caregivers may use massage to stretch the tissue and bring heat to the injury to increase blood flow. These and other treatments may help the bursitis heal faster. Exercises to stretch your Achilles tendon and make it stronger will be started after the bursitis has healed. You may gradually increase the amount of weight you put on your foot when caregivers say it is OK. You may be told to stop exercising if you feel any pain.

Prevention

To prevent bursitis of the heel in the first place, always keep proper form during exercise. In addition, don?t jump into exercises that are too intense without building up to them. Strengthen and flex your ankle.
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