Bursitis is the inflammation of a bursa, a small, fluid-filled sac. These sacs cushion bones, tendons, and muscles near joints. They reduce friction and absorb shock, allowing smooth movement. Inflamed bursae cause pain and swelling.
Understanding Bursitis of the Foot
Bursitis can affect various bursae in the foot. The foot contains several bursae. A common type is retrocalcaneal bursitis, located at the back of the heel between the Achilles tendon and the heel bone (calcaneus). This bursa cushions the tendon as it moves over the bone.
Another type is subcutaneous calcaneal bursitis, positioned between the skin and the Achilles tendon at the back of the heel. Intermetatarsal bursitis affects the ball of the foot, involving small bursae located between the long bones of the foot, known as metatarsals.
Identifying Bursitis: Causes and Symptoms
Foot bursitis often develops from factors that place excessive stress or friction on the bursae. Repetitive motions, such as prolonged walking, running, or jumping, are frequent contributors. Ill-fitting footwear is another common cause, as shoes that are too tight, lack support, or have worn-down heels can create pressure points. Direct trauma or injury to the foot can also lead to bursal inflammation.
Underlying medical conditions can increase the likelihood of foot bursitis. These include various forms of arthritis, such as rheumatoid arthritis or gout, and systemic diseases like diabetes. Structural foot issues, such as bunions, flat feet, or a bony enlargement on the heel known as Haglund’s deformity, can also contribute by altering foot mechanics and increasing pressure on bursae.
Symptoms of foot bursitis include localized pain, which often intensifies with activity or direct pressure. The affected area may appear swollen, feel tender to the touch, and exhibit warmth or redness. Movement of the affected joint can become stiff or limited, impacting daily activities. For intermetatarsal bursitis, a sensation of walking on a pebble or a burning feeling in the ball of the foot may be present.
Managing Bursitis: Diagnosis, Treatment, and Prevention
Diagnosing foot bursitis begins with a physical examination and review of medical history. The examination checks for tenderness, swelling, redness, and assesses the foot’s range of motion.
Imaging tests are used to rule out other conditions or gain a clearer view of the bursa. X-rays assess bone structure, ultrasound visualizes the bursa and fluid, and MRI provides detailed soft tissue assessment. Sometimes, fluid may be removed from the bursa for analysis, especially if infection is suspected.
Treatment for foot bursitis often begins with conservative measures. Rest, by avoiding aggravating activities, is important. Applying ice helps reduce swelling and pain. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can help manage pain and inflammation. Physical therapy may be recommended to improve flexibility and strength in the foot and ankle, often focusing on stretching the Achilles tendon if heel bursitis is present.
Modifying footwear, such as wearing properly fitted, supportive shoes with ample toe room, is a practical step. Orthotic inserts can provide additional support and help distribute pressure more evenly. For persistent inflammation, a healthcare provider might consider corticosteroid injections into the bursa to reduce swelling. Surgical removal of the bursa, known as a bursectomy, is a rarely needed option, reserved for severe cases that do not respond to other treatments after several months.
Preventing foot bursitis involves adopting habits that minimize stress on the bursae. Key preventative measures include:
- Wearing well-fitting shoes with good support and cushioning.
- Using orthotics, if advised, to maintain proper foot alignment.
- Gradually increasing activity levels, especially for running or other repetitive motions, for adaptation.
- Incorporating regular stretching and strengthening exercises.
- Avoiding prolonged pressure on vulnerable areas.
- Maintaining a healthy body weight.