Physical Rehabilitation For Bursitis Of The Feet

posted on 23 Aug 2015 21:38 by vazquezmzatycfytp
Overview

Retrocalcaneal bursitis is closely related to Haglund?s Deformity (or ?pump bumps?). If you have a bony enlargement on the back of the heel that rubs the Achilles tendon, it can cause the formation of a bursa (small fluid filled sack). It usually happens in athletes as shoes rub against the heel. The bursa can aggravated by the stitching of a heel counter in the shoe as well. It can make wearing shoes and exercising difficult. Another term used for this condition is ?pump bump? because it can frequently occur with wearing high heels as well. ?Retro-" means behind and ?calcaneus? means heel bone. So this is precisely where the bursitis (inflammation of the bursa) develops. Once it begins and you develop bursitis between the heel bone and the Achilles tendon, it can become even more painful. When most people first notice retrocalcaneal bursitis, it is because the skin, bursa and other soft tissues at the back of the heel gets irritated as the knot of bone rubs against the heel counter in shoes. The back of the shoes create friction and pressure that aggravate the bony enlargement and pinches the bursa while you walk.

Causes

Bursitis is commonly caused by overuse and repeated movements. These can include daily activities such as using tools, gardening, cooking, cleaning, and typing at a keyboard. Long periods of pressure on an area. For example, carpet layers, roofers, or gardeners who work on their knees all day can develop bursitis over the kneecap. Aging, which can cause the bursa to break down over time. Sudden injury, such as a blow to the elbow. Bursitis can also be caused by other problems, such as arthritis or infection (septic bursitis).

Symptoms

Pain or tenderness at the back of the heel around the Achilles region. Increased pain during activities with strong, repetitive calf contractions, walking (uphill), stair climbing, running, jumping. Pain may be worse with rest after activity (that night or the next morning) or at the beginning of the excercise. Pain when wearing shoes and the heel is getting rubbed. Bump forming on the back of the heel. Limping. Stiffness. Decreased range of motion. Redness and warmth (if the bursa gets infected).

Diagnosis

Magnetic resonance imaging (MRI) may demonstrate bursal inflammation, but this modality probably does not offer much more information than that found by careful physical examination. Theoretically, MRI could help the physician to determine whether the inflammation is within the subcutaneous bursa, the subtendinous bursa, or even within the tendon itself, however, such testing is generally not necessary. Ultrasonography may be a potentially useful tool for diagnosing pathologies of the Achilles tendon.

Non Surgical Treatment

Your GP may prescribe a short course of anti-inflammatory painkillers to reduce and control the painful inflammation that occurs and antibiotics in cases of septic bursitis. Applying a covered ice pack to the area after the initial injury may also significantly hasten the healing process by reducing the pain and swelling. Make sure the ice pack is covered to prevent any ice burn and for best results use the icepack regularly for 10-15 minutes with intervals of 30 minutes. Where possible it is advisable to avoid all aggravating movements and postures, however complete rest is not as this can lead to weakness and further shortening of the muscle. Massage and manipulative therapies can help loosen the surrounding muscles and tendons of the affected joint, reducing the pressure over the bursa and allowing it to heal faster. If the bursitis is chronic and not responding to treatment then your GP may refer you for a corticosteroid injection which will reduce the inflammation levels which will in turn reduce the pain levels experienced. Corticosteroid injections can have varied results. Surgery is a rare option when it comes to bursitis but occasionally it may be necessary for extremely chronic cases or to drain an infected bursa.

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.