Overview
Achilles tendon bursitis is inflammation of the fluid-filled sac (bursa) located either between the skin of the back of the heel and the Achilles tendon (posterior Achilles tendon bursitis) or in front of the attachment of the Achilles tendon to the heel bone (anterior Achilles tendon bursitis, retrocalcaneal bursitis). Typical symptoms include swelling and warmth and a tender spot at the back of the heel. The diagnosis is based on symptoms, an examination, and sometimes x-rays. Treatment is aimed at relieving the inflammation and, depending on the location of the Achilles tendon bursitis, eliminating the pressure on the back of the heel. The Achilles tendon is the tendon that attaches the calf muscles to the heel bone. Posterior Achilles tendon bursitis is often associated with formation of a bone prominence called Haglund deformity or ?pump bump? on the heel bone. Anterior Achilles tendon bursitis is also called Albert disease or retromalleolar bursitis.
Causes
Repetitive, vigorous movement, strenuous and unaccustomed activities that put pressure on a joint, or a blow or other injury can bring on bursitis. The cause can vary depending on where the bursitis occurs. In the shoulder, for example, it can be brought on by excessive strain, such as from serving in tennis. Kneeling on a hard floor can cause bursitis of the knee, and similarly, repeatedly resting the elbow on a hard surface (such as a desk) can cause bursitis in that joint. Arthritis, gout, and certain infections can also contribute to the problem. Bursitis, in fact, may signal the onset of arthritis. While getting older isn't a cause of bursitis, older people, especially older athletes, are more likely to develop the condition.
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
Gram stain. A lab test called a Gram stain is used to determine if certain troublesome bacteria are present. Not all bacteria can be identified with a Gram stain, however, so even if the test comes back negative, septic bursitis cannot be completely ruled out. White blood cell count. An elevated number of white blood cells in the bursa's synovial fluid indicates an infection. Glucose levels test. Glucose levels that are significantly lower than normal may indicate infection.
Non Surgical Treatment
Treatments include avoiding painful activities. Over-the-counter pain medications to control inflammation. Icepacks. Ultrasound treatment to reduce inflammation. Physical therapy to improve strength and flexibility. If other treatments don?t work, your doctor may inject steroids into the area. Surgery is rarely needed.
Surgical Treatment
Surgery is rarely need to treat most of these conditions. A patient with a soft tissue rheumatic syndrome may need surgery, however, if problems persist and other treatment methods do not help symptoms.
Achilles tendon bursitis is inflammation of the fluid-filled sac (bursa) located either between the skin of the back of the heel and the Achilles tendon (posterior Achilles tendon bursitis) or in front of the attachment of the Achilles tendon to the heel bone (anterior Achilles tendon bursitis, retrocalcaneal bursitis). Typical symptoms include swelling and warmth and a tender spot at the back of the heel. The diagnosis is based on symptoms, an examination, and sometimes x-rays. Treatment is aimed at relieving the inflammation and, depending on the location of the Achilles tendon bursitis, eliminating the pressure on the back of the heel. The Achilles tendon is the tendon that attaches the calf muscles to the heel bone. Posterior Achilles tendon bursitis is often associated with formation of a bone prominence called Haglund deformity or ?pump bump? on the heel bone. Anterior Achilles tendon bursitis is also called Albert disease or retromalleolar bursitis.
Causes
Repetitive, vigorous movement, strenuous and unaccustomed activities that put pressure on a joint, or a blow or other injury can bring on bursitis. The cause can vary depending on where the bursitis occurs. In the shoulder, for example, it can be brought on by excessive strain, such as from serving in tennis. Kneeling on a hard floor can cause bursitis of the knee, and similarly, repeatedly resting the elbow on a hard surface (such as a desk) can cause bursitis in that joint. Arthritis, gout, and certain infections can also contribute to the problem. Bursitis, in fact, may signal the onset of arthritis. While getting older isn't a cause of bursitis, older people, especially older athletes, are more likely to develop the condition.
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
Gram stain. A lab test called a Gram stain is used to determine if certain troublesome bacteria are present. Not all bacteria can be identified with a Gram stain, however, so even if the test comes back negative, septic bursitis cannot be completely ruled out. White blood cell count. An elevated number of white blood cells in the bursa's synovial fluid indicates an infection. Glucose levels test. Glucose levels that are significantly lower than normal may indicate infection.
Non Surgical Treatment
Treatments include avoiding painful activities. Over-the-counter pain medications to control inflammation. Icepacks. Ultrasound treatment to reduce inflammation. Physical therapy to improve strength and flexibility. If other treatments don?t work, your doctor may inject steroids into the area. Surgery is rarely needed.
Surgical Treatment
Surgery is rarely need to treat most of these conditions. A patient with a soft tissue rheumatic syndrome may need surgery, however, if problems persist and other treatment methods do not help symptoms.