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Overview<br>This is a very common condition that leads to foot pain . Once you understand what it actually is you will wonder why it does not occur more often, particularly in the foot. It is an inflamed bursal sac. A bursal sac is a sac filled with fluid that acts to lubricate and reduce the friction between two surfaces in the body, usually muscles and tendons as they glide over bony prominences, however their purpose in not limited to just muscles and tendons. The body contains literally hundreds of bursal sacs but in the foot there is just one naturally occurring (adventitious) bursal sac. It is located between the Achilles tendon and the heel bone (calcaneaus), otherwise known as an achilles tendon bursal sac.In this instance the Achilles tendon is protected from the pressure of the heel bone pressing against it when we walk.<br><br>Causes<br>The calcaneal bursa can become inflamed in patients with [http://kyungfiller.Wordpress.com/2015/06/22/hammer-toe-fusion-implants heel spurs] or in patients with poor-fitting shoes (eg, high heels). Inflammation can occur secondarily from Achilles tendinitis, especially in young athletes. Patients exhibit tenderness to palpation of the bursa anterior to the Achilles tendon on both the medial and lateral aspects. They have pain with movement, which is worsened with dorsiflexion.<br><br>Symptoms<br>Pain in the heel, especially with walking, running, or when the area is touched. Pain may get worse when rising on the toes (standing on tiptoes). Red, warm skin over the back of the heel.<br><br>Diagnosis<br>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.<br><br>Non Surgical Treatment<br>Rest and apply cold therapy or ice. Ice should not be applied directly to the skin as it may cause ice burns but wrap in a wet tea towel. Commercially available hot and cold packs are often more convenience than using ice. Taping the bursa with a donut shaped pad to take some of the pressure from footwear may help. A doctor may prescribe anti-inflammatory medication e.g. ibuprofen to reduce the pain and inflammation. Applying electrotherapy such as ultrasound may reduce inflammation and swelling. A steroid injection followed by 48 hours rest may be given for persistent cases. If the bursitis is particularly bad and does not respond to conservative treatment then surgery is also an option.<br><br>Surgical Treatment<br>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.<br><br>Prevention<br>Maintain proper form when exercising, as well as good flexibility and strength around the ankle to help prevent this condition. Proper stretching of the Achilles tendon helps prevent injury.
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Overview<br>Retrocalcaneal bursitis is a painful inflammation of the soft tissues at the attachment of the Achilles tendon to the back of the heel bone. The retrocalcaneus identifies the ?retro? or behind and ?calcaneus? or heel bone. Bursitis relates to inflammation of a bursa in the retrocalcaneal region. A bursa anatomically is a fluid filled sack that is located around tendinous attachments in the body. The retrocalcaneal bursa as identified in the photo 1 protects the Achilles tendon just prior to its insertion to the retrocalcaneal region. The retrocalcaneal bursa cushions the Achilles tendon and normally allows pain free motion of the Achilles tendon over the calcaneus.<br><br>Causes<br>Posterior heel pain can come from one of several causes. When a physician is talking about posterior heel pain, he or she is referring to pain behind the heel, not below it. Pain underneath the heel, on the bottom of the foot, has several causes including Tarsal Tunnel Syndrome. Plantar Fasciitis. [http://biancaaguillard.blogas.lt/?p=9&akst_action=share-this Heel Spurs].<br><br>Symptoms<br>Retrocalcaneal bursitis is very similar to Achilles bursitis as the bursae are very close in proximity and symptoms are almost identical however retrocalcaneal bursitis is a lot more common.  The symptoms of bursitis vary depending on whether the bursitis is the result of injury or an underlying health condition or from infection. From normal overuse and injury the pain is normally a constant dull ache or burning pain at the back of the heel that is aggravated by any touch, pressure like tight shoes or movement of the joint. There will normally be notable swelling around the back of the heel. In other cases where the bursa lies deep under the skin in the hip or shoulder, swelling might not be visible. Movement of the ankle and foot will be stiff, especially in the mornings and after any activity involving the elbow.  All of these symptoms are experienced with septic bursitis with the addition of a high temperature of 38?C or over and feverish chills. The skin around the affected joint will also appear to be red and will feel incredibly warm to the touch. In cases of septic bursitis it is important that you seek medical attention. With injury induced bursitis if symptoms are still persisting after 2 weeks then report to your GP.<br><br>Diagnosis<br>Your doctor will examine you, including an evaluation of your gait, while you are barefoot, your doctor will ask you to stand still and to walk in order to evaluate how your foot moves as you walk. An examination of your feet. Your doctor may compare your feet for any differences between them. Then your doctor may examine your painful foot for signs of tenderness, swelling, discoloration, muscle weakness and decreased range of motion. A neurological examination. The nerves and muscles may be evaluated by checking strength, sensation and reflexes. In addition to examining you, your health care professional may want to examine your shoes. Signs of excessive wear in certain parts of a shoe can provide valuable clues to problems in the way you walk and poor bone alignment. Depending on the results of your physical examination, you may need foot X-rays or other diagnostic tests.<br><br>Non Surgical Treatment<br>One of the most effective treatments for infracalcaneal bursitis is to temporarily avoid weight-bearing activities that put stress or strain on your heel bone. PRICE (protection, rest, hot/cold contrast compresses, compression, and elevation) is another good acute management technique for this foot problem. Changing your footwear is an effective long-term prevention and treatment tool for infracalcaneal bursitis. Footwear that possess a flat support base, a sufficiently wide toe box to accommodate natural toe splay, and a flexible sole are best for preventing and managing infracalcaneal bursitis. An integrated approach to this problem usually involves the use of padded socks that help reduce pressure, friction, and inflammation in your affected area. 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.<br><br>Surgical Treatment<br>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.

Última revisión de 11:27 12 jun 2017

Overview
Retrocalcaneal bursitis is a painful inflammation of the soft tissues at the attachment of the Achilles tendon to the back of the heel bone. The retrocalcaneus identifies the ?retro? or behind and ?calcaneus? or heel bone. Bursitis relates to inflammation of a bursa in the retrocalcaneal region. A bursa anatomically is a fluid filled sack that is located around tendinous attachments in the body. The retrocalcaneal bursa as identified in the photo 1 protects the Achilles tendon just prior to its insertion to the retrocalcaneal region. The retrocalcaneal bursa cushions the Achilles tendon and normally allows pain free motion of the Achilles tendon over the calcaneus.

Causes
Posterior heel pain can come from one of several causes. When a physician is talking about posterior heel pain, he or she is referring to pain behind the heel, not below it. Pain underneath the heel, on the bottom of the foot, has several causes including Tarsal Tunnel Syndrome. Plantar Fasciitis. Heel Spurs.

Symptoms
Retrocalcaneal bursitis is very similar to Achilles bursitis as the bursae are very close in proximity and symptoms are almost identical however retrocalcaneal bursitis is a lot more common. The symptoms of bursitis vary depending on whether the bursitis is the result of injury or an underlying health condition or from infection. From normal overuse and injury the pain is normally a constant dull ache or burning pain at the back of the heel that is aggravated by any touch, pressure like tight shoes or movement of the joint. There will normally be notable swelling around the back of the heel. In other cases where the bursa lies deep under the skin in the hip or shoulder, swelling might not be visible. Movement of the ankle and foot will be stiff, especially in the mornings and after any activity involving the elbow. All of these symptoms are experienced with septic bursitis with the addition of a high temperature of 38?C or over and feverish chills. The skin around the affected joint will also appear to be red and will feel incredibly warm to the touch. In cases of septic bursitis it is important that you seek medical attention. With injury induced bursitis if symptoms are still persisting after 2 weeks then report to your GP.

Diagnosis
Your doctor will examine you, including an evaluation of your gait, while you are barefoot, your doctor will ask you to stand still and to walk in order to evaluate how your foot moves as you walk. An examination of your feet. Your doctor may compare your feet for any differences between them. Then your doctor may examine your painful foot for signs of tenderness, swelling, discoloration, muscle weakness and decreased range of motion. A neurological examination. The nerves and muscles may be evaluated by checking strength, sensation and reflexes. In addition to examining you, your health care professional may want to examine your shoes. Signs of excessive wear in certain parts of a shoe can provide valuable clues to problems in the way you walk and poor bone alignment. Depending on the results of your physical examination, you may need foot X-rays or other diagnostic tests.

Non Surgical Treatment
One of the most effective treatments for infracalcaneal bursitis is to temporarily avoid weight-bearing activities that put stress or strain on your heel bone. PRICE (protection, rest, hot/cold contrast compresses, compression, and elevation) is another good acute management technique for this foot problem. Changing your footwear is an effective long-term prevention and treatment tool for infracalcaneal bursitis. Footwear that possess a flat support base, a sufficiently wide toe box to accommodate natural toe splay, and a flexible sole are best for preventing and managing infracalcaneal bursitis. An integrated approach to this problem usually involves the use of padded socks that help reduce pressure, friction, and inflammation in your affected area. 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.

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.