Alongside Achilles tendon injuries, bursitis is one of the most common causes of heel pain. There are many causes that can trigger bursitis in the heel. Careful diagnosis enablestargeted treatment. If treated correctly, bursitis of the heel usually heals well.
Here you will find further information and selected specialists for bursitis of the heel.
Bursae are small bags of tissue filled with clear fluid(synovial fluid) . They are found in almost all joints and in particular above
which are exposed to increased pressure or tension. There they lie directly on the bone and act like a cushion. As a result, they reduce the pressure and friction between the bone and the associated structures such as
The bursae on the heel bone lie in front of and behind the Achilles tendon © bilderzwerg / Fotolia
When the foot is pulled towards the back of the foot (dorsiflexion) in the ankle joint, the pressure in the bursa increases. The opposite movement (plantar flexion), i.e. when the foot is extended, reduces the pressure.
The bursa between the heel bone and Achilles tendon contains around 1.5 ml of fluid. It is designed to absorb shocks. It also distributes the load that the heel bone is subjected to when walking and running evenly across the ankle joint.
Painful inflammation can develop in the bursae. This type of bursitis is called bursitis in medical terminology. The calcaneus is also referred to by doctors as the calcaneus, so inflammation of the calcaneus is called bursitis calcanea. Excessive strain on the heel can overstress the bursa and surrounding structures.
In calcaneal bursitis, the bursa behind and below the heel becomes inflamed. Together with inflammation of the Achilles tendon, calcaneal bursitis is one of the most common causes of heel pain.
Athletes are particularly frequently affected by bursitis calcanea. Sports that are risky in this respect are
The wrong footwear can also irritate the heel area and cause inflammation. (Sports) shoes that have a heel cup or darts that are too hard put pressure on the heel and thus strain the bursa.
Congenital or accident-related deformities of the legs or feet (e.g. bowlegs or knock-knees) also have an unfavorable effect. If the feet bend inwards or outwards when walking or running, the bursa is exposed to additional stress.
Bursitis can be caused by sporting overload and tight shoes © pavel1964 / Fotolia
Pre-existing conditions can also promote inflammation, such as
Last but not least, some bacterial infections with, for example, staphylococci or streptococci lead to bursitis. This is referred to as septic inflammation. The bacteria can enter the bursa via the bloodstream or directly via an open wound.
The main symptom of bursitis calcaneais a stabbing pain in the heel area, which mainly occurs during movement. Other symptoms include
If there is heel pain, swelling and overheating in the heel area, immobilization is recommended first. If this does not lead to a significant improvement in the symptoms within a few days, a medical examination is recommended. This will allow the causes of the symptoms to be investigated in more detail and the necessary treatment procedures to be initiated.
The necessary examinations include
During the anamnesis interview, questions are asked about the complaints, the exact symptoms and possible triggers.
The foot and lower leg are then palpated as part of a physical examination. Here you are often asked to point out the point with the highest sensitivity to pain in order to make the examination as pain-free as possible.
If an infection is suspected after the medical history and physical examination, especially if there is fever, redness, swelling and discharge of pus, a blood sample is usually taken. Indications of an infection are elevated inflammation levels, such as a high white blood cell count.
In order to be able to assess the bursa, the joint and the Achilles tendon more precisely, an ultrasound examination (sonography) may be necessary. This is particularly recommended if the situation is unclear or if inflammation occurs repeatedly.
If abnormal findings are found here, or if the cause remains unclear even after the ultrasound examination, an MRI examination can provide a more precise insight into the bursa and the affected tissue on the foot and ankle.
If an injury to the bone is suspected, for example following an accident or after surgery, an X-ray examination can provide further important information on possible causes. It reveals pathological changes in the ankle joint or injuries to the heel bone, for example.
Bursitis of the calcaneus can usually be treated well and heals relatively quickly. It is important to react quickly and rest the painful area. The PECH scheme has proven to be a good rule of thumb for first aid:
The bursa does not always swell up again on its own once the inflammation has subsided. In this case, a puncture may be useful. In this minimally invasive procedure, the inflammatory fluid is drawn out of the bursa with a syringe.
Anti-inflammatory cortisone is then injected into the bursa sheath. The puncture can be an effective measure for protracted inflammation. However, the benefits and risks must always be carefully weighed up, as bacterial pathogens can enter the already irritated bursa through the puncture site and worsen the overall situation.
If other rheumatic or metabolic diseases have triggered the inflammation, the underlying disease is treated. The bursitis should then subside on its own.
If calcaneal bursitis is caused by bacteria, the bursa must be opened surgically and a drain inserted. This ensures that all the inflammatory fluid can flow out of the bursa. It is also usually necessary to take antibiotics to counteract bacterial growth.
Surgical removal of the inflamed bursa (bursectomy) is only necessary in rare cases: if the inflammation
Only a minor surgical procedure is required for removal. However, it requires subsequent immobilization and possibly the intake of antibiotics.
Bursitis of the calcaneus can have very different causes. Some of them can actually be prevented:
Although bursitis of the calcaneus is extremely painful, it can usually be treated well. If you take your body into consideration, bursitis can also be prevented.
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