Bursitis Of The Foot Treatment

Overview

Swelling and inflammation near a joint may be a sign of bursitis, a condition that involves buildup of liquid and inflammation in a bursa sac that cushions a joint. This condition has earned some interesting names over the years: housemaid?s knee, student?s elbow, and tailor?s bottom, to name a few. Simply put, bursitis is the inflammation of a bursa and buildup of fluid in the bursa sac. A bursa is a thin, slippery sac found around a joint that serves to reduce friction between bone and surrounding soft tissue, such as skin, muscles, ligaments and tendons. A bursa sac is made up of a synovial membrane, or synovium, that produces and contains synovial fluid. Excessive friction, a trauma, or other condition can irritate the synovium and cause it to become inflamed. The inflamed synovium will thicken and produce excess synovial fluid, and can cause symptoms such as localized swelling, skin redness and warmth, tenderness and pain. Of the approximately 160 bursae in the body, only a handful of them usually cause bursitis. These usual suspects are found in the knee, shoulder, elbow, and hip. Less frequently, bursitis may also occur in the heel, wrist, buttocks and big toe.

Causes

Bursitis, tendinitis, and other soft tissue rheumatic syndromes typically result from one or more factors. These include: Play or work activities that cause overuse or injury to the joint areas Incorrect posture Stress on the soft tissues from an abnormal or poorly positioned joint or bone (such as leg length differences or arthritis in a joint) Other diseases or conditions (rheumatoid arthritis, gout, psoriasis, thyroid disease, or an unusual drug reaction) Infection.

Symptoms

Symptoms of bursitis include pain in the heel, especially with walking, running, or when the area is touched. The skin over the back of the heel may be red and warm, and the pain may be worse with attempted toe rise (standing on tippy-toes).

Diagnosis

Carrying out a diagnosis for bursitis is fairly straightforward. The doctor will examine the affected area and ask the patient some questions about his/her recent activities. If the patient has a high temperature the physician may take a small sample of fluid from a bursa near the affected body part. The sample will be tested for bacteria, and perhaps also crystals. If the patient does not get better after treatment the doctor may carry out further tests so that he/she can eliminate the possibility that the symptoms might not be due to something else. These may include an x-ray, to make sure no bones are broken or fractured. Blood tests, to check for rheumatoid arthritis. A CT scan or MRI scan to see if there is a torn tendon.

Non Surgical Treatment

Treatment for soft tissue conditions focuses on reducing pain and inflammation, and on preserving mobility and preventing disability and recurrence. The treatment for many soft tissue conditions is similar. A doctor's recommendations may include a combination of rest, splints, heat and cold application, medications, physical therapy, or occupational therapy. A person with a soft tissue condition may try several treatments before he or she finds the best one for his or her specific condition.

Surgical Treatment

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.

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