In the foot we have a unique situation in that between the shoes that we wear and the ground that we walk on various parts of the foot are constantly being ?micro? traumatized meaning that every time we take a step we do a small amount of damage to a particular part of the foot and eventually that part of the foot begins to hurt. The body?s response to this micro-trauma is to create a bursal sac to initially protect the area but if micro-traumatized enough the bursal sac itself becomes inflamed and we have a bursitis.
Certain medical conditions and medications suppress people's immune systems and make them more susceptible to septic bursitis. For example, people with cancer, HIV/AIDS, lupus, alcoholism, chronic obstructive pulmonary disease (COPD), and diabetes may be more likely to get septic bursitis. History of inflammation of the bursa. Patients who have had bursitis in the past have an increased chance of getting it again. There may be more than one reason why the retrocalcaneal bursa is inflamed. In these cases, treatment should address all of the causes.
What are the symptoms of heel bursitis? pain, swelling, tenderness, redness, and/or warmth at either the bottom of the heel or top of the heel, depending on the degree of swelling, pain may be a dull ache or substantial enough to cause limping, running, jumping, and walking activities may exacerbate pain, wearing poorly fitting, tight, or high-heeled shoes may exacerbate pain.
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
Many cases of retrocalcaneal bursitis can be resolved with self-care that is focused on reducing inflammation and eliminating activities or positions that aggravate the bursa. Some cases, however, may become more serious and require more medical interventions. Rarely, surgery is needed. Following the R.I.C.E. formula, or Rest, Ice, Compression, and Elevation, is often sufficient to treat aseptic bursitis. Rest. People with retrocalcaneal bursitis should avoid activities that irritate the bursa, such as jogging or excessive walking. Ice. Applying a cold compress to the back of the ankle for about 20 minutes two or three times a day may help alleviate symptoms and decrease swelling. Compression. An elastic medical bandage (e.g. Ace? bandage) wrapped around the affected heel and ankle can help control swelling. Elevating the affected heel. Sitting down with the leg elevated on a stool or lying down with the foot elevated on a pillow can help reduce blood flow to the area, thereby reducing inflammation.
Surgery is rarely need to treat most of these conditions. A patient with a soft tissue rheumatic syndrome may need surgery, however, if problems persist and other treatment methods do not help symptoms.