Bursitis and Heel Pain

A bursa is a small fluid-filled sac that forms in areas of extra rubbing and friction. They are usually present with a bone deformity as the bone is pressed against other structures like a tendon or against the ground as you walk. The bursa acts like a shock absorber and is a way for your body to protect you from damage. When this bursa or sac-like structure becomes swollen and inflamed it is called bursitis. The bursa may have an anatomical meaning normally present, or it may be adventitious meaning, only present because of a problem. Many bursa are present and do not cause pain.

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 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.
Causes of bursitis can be any kind of friction between bone and soft tissue. The most common cause is due to abnormal pronation.
Prevention can be accomplished by controlling your foot structure with good supportive shoes or arch supports. Pay attention to early signs of friction like blister formation. This tells you where the areas that are more likely to cause a bursa to form and subsequently bursitis.
Diagnosis is first by clinical suspicion of symptoms. This can be mistaken for gout or infection, especially in the big toe region. A diagnosis of bursitis is usually used in combination of the underlying cause, for instance a bunion deformity, Haglund's Deformity, or Heel Spur Syndrome. Many times the cause needs to be addressed to rid the problem of bursitis.
Podiatric care may include using an anti-inflammatory oral medication or an injection of medication and local anesthetic to reduce the swelling in the bursa. An injection may be used for both the diagnosis and treatment. When you go to your doctor, x-rays are usually required to evaluate the structure of your foot and ankle to ensure no other problems exist in this area. They may advise you on different shoewear or prescribe a custom-made orthotic to try and control the foot structure, especially if you have excessive pronation. Sometimes patients are sent to physical therapy for treatment as well. To aid in relief of pressure points, some simple padding techniques can be utilized. Most all patients respond to these conservative measures once the area of irritation is removed.
Surgery is rarely done strictly for treatment of a bursitis. If any underlying cause is the reason, this may be addressed surgically. During the surgery for other conditions, the bursa may be seen and removed surgically.
If you are having pain because of a bursa or heel pain, and do not currently see a podiatrist, call our Rocky Hill or Middletown office to make an appointment.
Jeffrey S. Kahn, DPM
Connecticut Foot Care Centers
Heel Pain Doctor in CT
Podiatrist in Rocky Hill and Middletown, CT
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