Bursitis is the inflammation of the small fluid-filled pads, or bursae, that act as cushions among your bones and the tendons and muscles near your joints. Bursitis occurs when the bursa become
inflamed, and often occurs in joints that perform frequent and repetitive motion. The foot only contains one naturally occurring bursal sac between the Achilles tendon and the heel bone, which
protects the Achilles from the pressure against the heel bone during ambulation. However, shoes may put pressure on this bursa. The bursa might also incur trauma from walking on hard ground. And,
though they are not naturally occurring, bursa sacs can also form, and become inflamed, in other parts of the foot, including the bottom of the heel, and the metatarsal plate, the outside of the foot
below the fifth toe, and so on.
Bursitis can develop for several reasons, including repetitively engaging in the same motion, or example, lifting objects above your head for work. Putting a lot of pressure on a bursa for an
extended period of time. Leaning on your elbows or kneeling (for example, to lay carpet) can cause bursitis in the elbows or knees. If you sit for long periods of time, especially on hard surfaces,
you may develop bursitis in your hip. Wearing shoes with a stiff back that rubs against the back of the ankle can cause Achilles tendon bursitis. Trauma. The bursae at the knee and elbow are close to
the surface of the skin, and if you fall directly on your elbow or the knee, you can rupture, injure or puncture a bursa. Infection. Known as septic bursitis, it?s the result of bacteria infecting a
bursa. It can occur from an infection traveling from another site or following an accident that ruptures the bursa. Even scraping the skin on your elbow or getting a mosquito bite that breaks the
skin near the olecranon bursa (near the elbow) can lead to bursitis. Other joint disorders, such as rheumatoid arthritis, osteoarthritis and gout, or health conditions.
Posterior heel pain is the chief complaint in individuals with calcaneal bursitis. Patients may report limping caused by the posterior heel pain. Some individuals may also report an obvious swelling
(eg, a pump bump, a term that presumably comes from the swelling's association with high-heeled shoes or pumps). The condition may be unilateral or bilateral. Symptoms are often worse when the
patient first begins an activity after rest.
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
It is important to treat bursitis in the early stages to reduce the symptoms, minimize damage and maintain motion and strength in your foot. Resting your ankle, using proper cushioning, wearing
comfortable footwear and reducing any activities that add pressure on your bursa will help to reduce your pain and bursitis inflammation.
Surgery to remove the damaged bursa may be performed in extreme cases. If the bursitis is caused by an infection, then additional treatment is needed. Septic bursitis is caused by the presence of a
pus-forming organism, usually staphylococcus aureus. This is confirmed by examining a sample of the fluid in the bursa and requires treatment with antibiotics taken by mouth, injected into a muscle
or into a vein (intravenously). The bursa will also need to be drained by needle two or three times over the first week of treatment. When a patient has such a serious infection, there may be
underlying causes. There could be undiscovered diabetes, or an inefficient immune system caused by human immunodeficiency virus infection (HIV).