Achilles bursitis is one of those injuries that can really bring down the quality of your life. Anyone, young or old, can suffer from this injury, and if you’re active this condition will keep you from doing the things you love to do. It will even start interrupting any of your normal daily tasks and make living life harder than it really needs to be. Fortunately for you, professional athletes have had access to state of the art treatment therapies for years that allow them to heal more quickly and completely than you or I. This is why athletes that have a serious heel bursitis injury can often get back in the game in a matter of weeks while you could suffer for months or even years (in chronic cases).
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.
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.
In addition to a complete medical history and physical examination, diagnostic procedures for bursitis may include the following. X-ray. A diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film. Magnetic resonance imaging (MRI). A diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body. Ultrasound. A diagnostic technique that uses high-frequency sound waves to create an image of the internal organs. Aspiration. A procedure that involves removal of fluid from the swollen bursa to exclude infection or gout as causes of bursitis. Blood tests. Lab tests that are done to confirm or eliminate other conditions.
Non Surgical Treatment
Over-the-counter or custom heel wedges may help to decrease the stress placed on the attachment of the achilles tendon and the associated bursa. If these interventions are ineffective, then some health care providers may inject a small amount of steroids into the bursa. If the condition is associated with Achilles tendonitis, then casting the ankle to prevent motion for several weeks can be effective. Very rarely, surgery may be necessary to remove the inflamed bursa.
Surgery is rarely need to treat most of these conditions. A patient with a soft tissue rheumatic syndrome may need surgery, however, if problems persist and other treatment methods do not help symptoms.