Calcaneal Bursa (heel)
What is Calcaneal Bursa ?
Calcaneal bursa is defined as a medical condition characterized by inflammation at the back of the heel bone.
Bursa is a small sack of fluid between the heel bone and the fat pad, to provide lubrication and cushioning for easy movement. This sac becomes inflamed with over use and results in pain. Meanwhile, the calcaneus is referred to as the heel bone. The condition is known to be very painful upon rising in the morning. Patients normally complain that they are hardly mobile for the first 30 minutes every morning.
An episode of calcaneal bursa is often associated with long standing plantar fasciitis or heel spur syndrome where swelling and inflammation leads to the additional problem of formation of the calcaneal adventitious bursa.
The Symptoms
Deep discomfort under the heel while running or at rest, The pain and tenderness persists as the foot is moved upwards or downwards.
As in the case of Achilles Tendonitis, the pain also worsens with the increase in activity.
The patient also experiences a greater severity in pain as he/she tries to walk after a period of rest.
Severe redness along with sensations of increased heat in the feet.
In addition to the swelling over the back of the heel, the patient will also feel acute tenderness and pain when he/she tries to apply even light pressure.
The swollen heel may look redder than the other one and the swelling is so hard at times that it almost feels like a bone.
In some cases, inward bending of the hind part of the foot is also observed. However, there is no arch pain associated with this type of condition.
Causes
Calcaneal bursa occurs primarily due to the changes in the bursa sac. The sac becomes engorged with fluid while the patient is sleeping. This enlarged sac is extremely painful when pressure is exerted upon rising.
Since the body is in a weight-bearing position during the day, the fluid gets pushed out of the sac, which further returns when the body is at rest, mostly
in the evenings.
Heel spurs and excess weight injury normally lead to the occurrence of the condition.
Here we list some of he most important causes:
• History of foot, ankle or heel injury
• Repeated heel injury
• Excessive increase in running mileage
• Prolonged standing
• Obesity
The occurrence of the condition is often associated with repetitive trauma or overuse and is further aggravated by pressure, for instance in the case of athletes wearing tight-fitting shoes. It is often related to conditions such as gout, rheumatoid arthritis, and seronegative spondyloarthropathies.
Prevention
Wear athletic shoes with good shock absorption in the heel
Footwear with flexibility and good support to control side-to-side motion
Avoid heels of more than 1 to 1-1/2 inches in regular wear
Wear open-back shoes to relieve pressure
Treatment Options
The first form of treatment is the use of non-steroidal anti-inflammatory medication and ice therapy.
One of the most common forms of treatment is the
administration of a cortisone injection directly into the bursa to reduce its size and also to lessen the pain related to the heel bone.
Equipment such as heel wedges and sole supports can also be used to decrease the stress on the heel. Research suggests that improving strength through physical therapy is an excellent way to prevent recurrence of calcaneal bursa.
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