Bursitis is the inflammation of a bursa within the body. A bursa is a fluid-filled sac that cushions some of the major joints, allowing bones, gliding muscles, and tissues to exist together without harming each other. It aids in reducing the friction between bones and the soft tissues above it. Though there are bursae all over the body, the main ones are located in the knee, elbow, shoulder, hip, and heel. These are also the ones that are the most often injured. Still, however, when you hear the word ?bursitis?, the person is usually referring to their shoulder, but it could also refer to any of the preceding areas--such as the second most common one, the hip.
Bursitis occurs when the bursae become irritated or infected, often causing pain on movement. When infection is involved, medical intervention is necessary to fight the underlying infection and prevent it from spreading, when infection is not involved, prompt medical attention can prevent the condition from becoming worse over time.
Symptoms of bursitis usually occur after rest and relaxation. Upon activity there is usually more intense pain in the area of the bursa. The common areas to have a bursitis in the foot are in the bottom of the heel, behind the heel near the attachment of the Achilles Tendon as well as along the side of a bunion. A bursa may also form in multiple areas especially along the metatarsal heads, or "ball" of your foot. You may actually feel the sac like fluid when rubbing the area of pain.
Like all other forms of bursitis, initially the physician will take down the history of symptoms experienced by the patient, this will be followed by a detailed physical examination which involves checking for inflammation signs like pain, redness, and warmth of the heel area. The physician might examine further by moving the ankle a little to determine the exact location of pain. Further diagnostic tests including x-ray, bone scans, and MRI scan might be suggested if required.
Non Surgical Treatment
The initial course of treatment for this problem, after the usual ice and ibuprofen/aspirin routine or course, is to change footwear, especially if the onset of the problem was coincidental with a new pair of shoes. If this fails, a small heel lift (no more than ??) in both shoes may provide enough biomechanical adjustment to relieve the stress and/or friction over the area. If there is still no improvement, complete rest from running is probably advised, along with a professional consultation.
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).
Do not run if you have pain. When you begin running again, avoid running fast uphill or downhill until the tendon is fully healed. Start exercising when caregivers say that it is OK. Slowly start exercise such as bicycling when caregivers say it is OK. When doing exercises that put pressure on the ankles, such as running or walking, exercise on flat, even surfaces. Avoid doing these exercises on very hard surfaces such as asphalt or concrete. Stretch before exercising. Always warm up your muscles and stretch gently before exercising. Do cool down exercises when you are finished. This will loosen your muscles and decrease stress on your heel. Wear heel protectors. Use soft foam or felt heel pads (wedges or cups) to help decrease pressure against your heel. Ask your caregiver which heel pads are the best for you. Wear well-fitting shoes. Buy running or exercise shoes that support and fit your feet well. Do not wear low-cut shoes. Talk to your caregiver or go to a special exercise footwear store to get well-fitting athletic shoes. Ask your caregiver if you should wear specially-made shoe inserts called orthotics (or-THOT-iks). Orthotics can line up your feet in your shoes to help you run, walk and exercise correctly.