Calcaneal bursitis - causes and diagnosis, medical and surgical treatment

Infectious disease of the joints about the bag in the region of the tendon is called heel bursitis. The pathology is characterized by an acute course of the inflammatory process, increased secretion of exudative fluid is of a different nature (depending on etiology), pain symptoms. Bursitis on the heel often causes expansion of the affected area on the fabric over the calcaneum by the tendon and may continue to spread to the articular bags of leg muscles.

Bursitis of the heels1

If you get an infection in the cavity of the ankle joint starts reactive inflammation of the synovial membranes, exciting the surrounding tissue. Timely complex therapy, which is assigned depending on the form of the disease (acute, subacute, chronic or recurrent). If this pathology on the heel is not time to diagnose and do not prescribe treatment, the inflammation goes into a chronic bursitis, when the signs of the disease is not expressed, but tissue will decay, resulting in severe complications up to loss of ability to walk.

Reasons

Bursitis of the heel provoke three main categories of factors:

  1. The external impact. Provokes the inflammation of the bursal infectious nature. Uncomfortable, not fitting shoes, high-heeled shoes contribute to the mechanical damage of the synovial Bursa of the tendon. The cause of bursitis can also become injuries (sprains, bruises, stretching), inefficient physical activity, obesity second and third degree, metabolic disorders, endocrine disorders.
  2. Infection. When pathogens enter the tendon the bag after the violation of the integrity of soft tissue (cut, puncture), the possible development of an infectious inflammation. In addition, the disease can occur due to concomitant or past diseases of bacterial nature (osteomyelitis, arthritis, arthrosis). In some cases, chronic inflammation induce the development of bursitis (eg, chronic pyelonephritis, or tonsillitis).
  3. Congenital anatomical abnormalities of the structure of the foot. For example, when in true gigantism of the foot, tendons, and muscles are under constant tension (even at rest), furthermore, when this anomaly man is hard to find or custom made comfortable shoes that leads to constant non-infectious inflammation.

Symptoms

Bursitis is characterized by all the classic symptoms of acute inflammation of soft tissues. The symptoms and their combination can vary depending on the stage of disease and etiology. The classic picture of bursitis includes the following symptoms:

  • local pain symptoms;
  • pain during walking, prolonged stress;
  • redness of the affected area;
  • the stiff joints;
  • fever (if the bursitis infectious nature);
  • fistula (purulent bursitis);
  • recurrent calcareous bursitis is characterized by the formation of hillocks, heel spurs.

Inflammation of the joint capsule of the heel in children

The disease often occurs in children who from an early age in sports (sports or artistic gymnastics, athletics). Heel bursitis – a frequent phenomenon in children, who often suffer from respiratory infections, and in the case of genetic predisposition to diseases of the osteoarticular system (arthritis or osteoarthritis).

Inflammation of the joint capsule is typical for children from 4 to 12-13 years. Many parents ignore a child's complaints of pain and swelling in the joints, blaming the symptoms on a frequent injury in training or in active games, so the children's bunion often becomes chronic and causes complications. Diagnosis of inflammation of joint tissues and treatment are the same as in adults.

Types

Klassificeret bursitis, based on the location of the inflammatory focus, however, the division of diseases into types is arbitrary, since different types usually occur together or superimposed on one another. Theoretically there are the following types of inflammation of the joint capsule:

  1. Podpaliny bursitis – localized in the bottom of the heel.
  2. Achilles bursitis – inflammation in the area of the Achilles tendon.
  3. Tandoori – damage of the surrounding tissue of the tendon.
  4. Retrocalcaneal bursitis – inflammation of soft tissue without hitting bone.

Diagnosis

To make a diagnosis and assign effective treatment requires a number of laboratory and instrumental studies:

  1. Analysis of the serous exudate, synovial fluid from the articular handbags for determining the presence, the type of pathogen.
  2. X-rays to determine the area of destruction.
  3. Medical history, visual examination of the affected limb.
  4. General analysis of blood, urine can help to establish the etiology of the disease.

Treatment

Methods of complex therapy of the disease depend on the type, shape, stage of pathological process. Treatment includes the following activities:

  1. Immobilization of the affected joint, the complete elimination of load on the limb.
  2. Drug therapy. The use of non-steroidal anti-inflammatory drugs that are aimed at preventing the spread of inflammation to the neighbouring tissues, treatment of the lesion in the joint cavity. In addition, infectious bursitis antibiotics are used in tablets and ointment for local treatment and pain medication.
  3. Physiotherapy. To restore the mobility and vascularity of the joint use massage, physiotherapy and other impacts, which are aimed at improving muscle tone and tissue regeneration.
  4. Surgical treatment. Depending on the severity of the disease use puncture bags, total removal of the Bursa (with frequent relapses of inflammation).

Drug therapy

Bursitis of the heels2

The use of drugs, the main method of treatment of inflammation in the joint capsule. The simultaneous use of systemic and topical anti-inflammatory drugs, antibiotics. Chondroprotectors are often prescribed to improve tissue repair and multivitamins to increase immunity.

Physical therapy

For the treatment and prevention of recurrence of bursitis used methods of physiotherapy, aimed at restoring the microcirculation of the connective tissues and eliminates pain symptom:

  1. Electrophoresis. The method of electrotherapy, which consists in complex influence on the affected area galvanization (DC low power and voltage) and anti-inflammatory drugs. Through electrophoresis dilate blood and lymph vessels, improves local blood circulation.
  2. Magnetic physical therapy. Acts directly on inflammatory lesion, the underlying cause of pain and nerve endings that conduct pain signals. The magnetic field has a calming effect on the Central nervous system, increases the permeability of the vessel walls.
  3. Heat therapy with paraffin. Has analgesic effect on the affected joint, allows you to recover quickly after surgery.

Proper nutrition

To help the body cope with disease with bursitis, you should consume foods that are rich in vitamins a, C, E:

  1. Of animal origin: lean meat chicken, Turkey, beef, fish, liver, seafood, cheese, milk.
  2. Of vegetable origin: cabbage, carrots, beets, sweet bell pepper, pumpkin seeds, potatoes.

In chronic, acute bursitis should be to minimize the consumption of salt, fat, fried foods, smoked meats, semi-finished products. It is necessary to completely eliminate any alcohol, fast food, mayonnaise and other fatty sauces. In addition, to prevent inflammation, in addition to consume gelatin, which contains collagen, beneficial for connective tissue, multivitamin.

Surgery

With the ineffectiveness of conservative therapy the patient is administered a surgery, which is carried out in two ways: little invasive intervention (puncture) and in full operation, during which inflamed the joint capsule is removed. Puncture carried out with not complicated acute primary disease, local anesthesia of the joint cavity and remove the liquid, injected anti-inflammatory and antibacterial drug. After the intervention impose a sterile bandage, prescribe bed rest for 3-5 days.

The removal of the joint capsule is performed with frequent relapses of the disease. The operation is performed under General anesthesia, fully or partially excision of the diseased tissue. Access to joint is performed using a large incision or equipment for endoscopy through small punctures on opposite sides. Surgeon secretes synovial bag holds its excision, and then ligated operational access and secures drainage. The operation lasts up to 40 minutes.

Postoperative treatment of heel inflammation

After carrying out of operative treatment of calcaneal inflammation, the foot is immobilized for 2-3 weeks with a cast or tight winding . The patient needs to take broad-spectrum antibiotics to prevent postoperative infections of wounds, Heparin for 2-3 days for the prevention of deep vein thrombosis of the affected limb.

The heel bursitis treatment of folk remedies

For effective treatment of bursitis should people use home therapies in combination with medication and physical therapy:

  1. Home warming the affected area in traumatic bursitis. For this purpose, pharmacy bottle or a plastic bottle with warm water wrapped in a towel. You can heat up in a frying pan large salt and pour it in the pouch of tissue. However, it is forbidden to warm infectious inflammation, because it can lead to the aggravation of the disease, distribution of lesions within the nasal cavity, fistulas and abscesses, the melting of bones.
  2. A compress of cabbage leaf. This home remedy works effectively in inflammation of the soft tissues. To prepare a compress a few large cabbage leaves, lightly beat off, then struck the heel, they must be wrapped tightly, it is good to fix with a bandage or gauze from top to wear warm woolen socks. Leave overnight, repeat the procedure every other day.
  3. Baths. Active anti-inflammatory effect of the bath of a decoction of birch leaves with the addition of pine needles pine or fir. Plants should be washed, cleaned of debris, and then crushed. Cover with water in an amount of 0.5 l, put on fire and boil for 5-10 minutes to allow the broth to cool and add to the bowl with warm water. Use the tub every day, at night before bedtime for 7-10 days.

Before you start using folk remedies, you should consult with a specialist and diagnose the exact type, stage of the disease. In addition, baths, compresses can be applied only in absence of injuries to the skin , ulcers, rashes, subcutaneous inflammatory processes. It is not recommended to use traditional methods of treatment in the early postoperative period.

Prevention

To prevent the development of inflammation of the heel bags, you must perform the following recommendations:

  • For injuries of the ankle joint should take anti-inflammatory drugs.
  • When extra weight is necessary to bring him back to normal.
  • It is time to treat infectious diseases.
  • After the injury should record the ankle, to ensure complete rest of the limb.
  • With intense sports it is necessary to take chondroprotectors and preparations containing collagen.
25.02.2018