Heel pain can also be caused due a condition called Bursitis which is constant irritation of the heel’s natural cushion (bursa). This can lead to additional pain at the back of the heel when the ankle is moved and there may be swelling on both sides of the Achilles tendon. Useful treatments for Heel bursitis are anti-inflammatory medications such as aspirin and Ibuprofen gel/tablets. Cold ice-pack compresses can be useful in reducing any swelling. In conjunction to these treatments it is important to stabalise and protect the heel. Gel heel pads will help to let the inflamed bursa settle down, however in severe chronic cases sometimes the use of Cortisone injections may be indicated.
Bursitis of the Achilles tendon is caused by the irritation and inflammation of the retrocalcaneal bursa, a small fluid-filled sac located in the back of the ankle that acts as a cushion and lubricant for the ankle joint. Possible causes of Achilles tendon bursitis include aging, Factors related to the aging process, including the onset of rheumatoid arthritis and gout, can deteriorate the bursa. Overuse of ankle. Excessive walking, uphill running, jumping, and other aggressive exercise regimens, especially without proper conditioning, can cause irritation to the bursa. Trauma. Sudden injury to the ankle joint, or trauma caused by rigid or improperly fitted shoes, can increase the chances of developing bursitis.
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
Treatments should involve decreasing swelling, relieving pain and stress on the Achilles, correcting any biomechanical dysfunction (over-pronation or flat feet), treating scar tissue, and then restoring strength and movement. If you are performing an activity that could cause further trauma to the bursa, it is recommended that you protect the area with padding and/or proper footwear to prevent further irritation or damage.
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.
Maintain proper form when exercising, good flexibility, and strength around the ankle to help prevent this condition from arising. Proper stretching of the achilles tendon helps prevent injury.