Bursitis is the painful inflammation of the bursa, a padlike sac found in areas subject to friction. Bursae cushion the movement between the bones, tendons and muscles near the joints. Bursitis is
most often caused by repetitive movement and is known by several common names including weaver's bottom, clergyman's knee, and miner's elbow, depending on the affected individual's occupation and
area of injury.
Inflammation of the bursa causes synovial cells to multiply and thereby increases collagen formation and fluid production. A more permeable capillary membrane allows entrance of high protein fluid.
The bursal lining may be replaced by granulation tissue followed by fibrous tissue. The bursa becomes filled with fluid, which is often rich in fibrin, and the fluid can become hemorrhagic. One study
suggests that this process may be mediated by cytokines, metalloproteases, and cyclooxygenases.
The following are the most common symptoms of bursitis. However, each individual may experience symptoms differently. Bursitis can cause pain, localized tenderness, and limited motion. Swelling and
redness may occur if the inflamed bursa is close to the surface (superficial). Chronic bursitis may involve repeated attacks of pain, swelling, and tenderness, which may lead to the deterioration of
muscles and a limited range of motion. The symptoms of bursitis may resemble other medical conditions or problems. Always consult your doctor for a diagnosis.
Diagnosis is first by clinical suspicion of symptoms. This can be mistaken for gout or infection especially in the big toe region. A diagnosis of bursitis is usually used in combination of the
underlying cause, for instance a bunion deformity, Haglund's deformity, or Heel Spur Syndrome. Many times the cause needs to be addressed to rid the problem of bursitis.
Non Surgical Treatment
Here are some of the most effective treatments for infracalcaneal bursitis Temporarily avoiding weight-bearing activities that put stress or strain on the heel bone can very helpful in treating
infracalcaneal bursitis. PRICE (protection, rest, hot/cold contrast compresses, compression, and elevation) is another good acute management technique for this foot problem. Changing footwear is an
effective long-term prevention and treatment tool for infracalcaneal bursitis. Shoes that possess a flat support base from heel to toe, a sufficiently wide toe box to accommodate natural toe splay,
and a flexible sole that can be easily bent or twisted are best for preventing and managing infracalcaneal bursitis. An integrated approach to this problem usually involves the use of padded socks or
heel cups to help reduce pressure, friction, and inflammation under the heel. Natural anti-inflammatory agents can also be helpful in quelling inflammation, reducing pain, and improving treatment
times for infracalcaneal bursitis. In rare cases, more aggressive treatment methods may be required, such as cortisone injections or surgery to drain the bursal sac. Always consult your physician
before beginning any healthcare regimen designed to treat infracalcaneal bursitis.
Surgery. Though rare, particularly challenging cases of retrocalcaneal bursitis might warrant a bursectomy, in which the troublesome bursa is removed from the back of the ankle. Surgery can be
effective, but operating on this boney area can cause complications, such as trouble with skin healing at the incision site. In addition to removing the bursa, a doctor may use the surgery to treat
another condition associated with the retrocalcaneal bursitis. For example, a surgeon may remove a sliver of bone from the back of the heel to alter foot mechanics and reduce future friction. Any
bone spurs located where the Achilles attaches to the heel may also be removed. Regardless of the conservative treatment that is provided, it is important to wait until all pain and swelling around
the back of the heel is gone before resuming activities. This may take several weeks. Once symptoms are gone, a patient may make a gradual return to his or her activity level before their bursitis
symptoms began. Returning to activities that cause friction or stress on the bursa before it is healed will likely cause bursitis symptoms to flare up again.