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Bursitis Foot Pad

RalphDominquez586949 2017.06.11 22:11 조회 수 : 236

Overview
Bursitis is the inflammation of a bursa within the body. A bursa is a fluid-filled sac that cushions some of the major joints, allowing bones, gliding muscles, and tissues to exist together without harming each other. It aids in reducing the friction between bones and the soft tissues above it. Though there are bursae all over the body, the main ones are located in the knee, elbow, shoulder, hip, and heel. These are also the ones that are the most often injured. Still, however, when you hear the word ?bursitis?, the person is usually referring to their shoulder, but it could also refer to any of the preceding areas--such as the second most common one, the hip.

Causes
Overtraining in an athlete. Tight or poorly fitting shoes that produce excessive pressure at the posterior heel. Haglund deformity. Altered joint axis. Inflammation of the calcaneal bursae is most commonly caused by repetitive (cumulative) trauma or overuse, and the condition is aggravated by pressure, such as when athletes wear tight-fitting shoes. Retrocalcaneal bursitis may also be associated with conditions such as gout, rheumatoid arthritis, and seronegative spondyloarthropathies. In some cases, retrocalcaneal bursitis may be caused by bursal impingement between the Achilles tendon and an excessively prominent posterosuperior aspect of the calcaneus (Haglund deformity). In Haglund disease, impingement occurs during ankle dorsiflexion.

Symptoms
Unlike Achilles tendinitis, which tends to manifest itself slightly higher on the lower leg, Achilles tendon bursitis usually creates pain and irritation at the back of the heel. Possible signs of bursitis of the Achilles tendon include difficulty to rise on toes. Standing on your toes or wearing high heels may increase the heel pain. Inflammation and tenderness. The skin around your heel can become swollen and warm to the touch. Redness may be visible. Pain in the heel. Pain tends to become more prominent when walking, running, or touching the inflamed area. Stiffness. The back of your ankle may feel a little stiff due to the swelling of the bursa.

Diagnosis
Your doctor will take a history to find out if you have the symptoms of retrocalcaneal bursitis. By examining your ankle, he or she can generally tell the location of the pain. The physician will look for tenderness and redness in the back of the heel. The pain may be worse when the doctor bends the ankle upward (dorsiflex), as this may tighten the achilles tendon over the inflamed bursa. Alternatively, the pain may be worse with toe rise, as this puts stress on the attachment of the achilles tendon to the heel bone. Imaging studies such as X-ray and MRI are not usually necessary at first. If initial treatment fails to improve the symptoms, these studies may be obtained. MRI may show inflammation.

Non Surgical Treatment
Physiotherapy treatment is vital to hasten the healing process, ensure an optimal outcome and reduce the likelihood of injury recurrence in all patients with retrocalcaneal bursitis. Treatment may comprise soft tissue massage (particularly to the calf muscles), joint mobilization (of the ankle, subtalar joint and foot), dry needling, electrotherapy (e.g. ultrasound), stretches, the use of heel wedges, the use of crutches, ice or heat treatment, arch support taping, the use of a compression bandage, exercises to improve strength, flexibility, balance and core stability, education, anti-inflammatory advice, activity modification advice, biomechanical correction (e.g. the use of orthotics), footwear advice, a gradual return to activity program.

Surgical Treatment
Surgery is rarely done strictly for treatment of a bursitis. If any underlying cause is the reason, this may be addressed surgically. During surgery home remedies for illness other conditions, a bursa may be seen and removed surgically.
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