Achilles bursitis is a painful condition caused by an inflammation of a bursa. Patients often experience this if they wear tight shoes, participate in a high-impact sports, have very tight calves, or suddenly change their exercise routine. At Island Foot Clinics in Kelowna, BC and Victoria, BC, we rarely recommend surgery for bursitis. Instead, there are several noninvasive treatments available.
Can Achilles Bursitis Be Treated Without Surgery?
Bursae are small sacs that help your bones to glide over each other more easily and absorb shock. There are two bursae near your heel. The first one lies between your Achilles tendon and your heel bone, and the second is located behind the heel. When one of these sacs gets irritated, you’ll experience pain, tenderness, warmth, and a change in the skin color around your heel.
Bursitis usually isn’t a dangerous or long-lasting condition, and it can almost always be treated without surgery. You might be asked to rest and ice your foot, take over-the-counter painkillers, wear only soft and supportive shoes, and see a physical therapist. Sometimes, antibiotics or corticosteroids are prescribed.
When you first get diagnosed with heel bursitis, your doctor might simply ask you to rest your leg. Since the pain is caused by an inflammation, it’s important not to put further stress on the heel joint. Icing can also help because it increases the blood flow to your leg and therefore speeds up your body’s natural healing mechanism. Put a cold compress or ice pack on your heel for 20 minutes two or three times a day.
Sometimes, doctors provide patients with topical creams and ask them to take over-the-counter pain medications. However, it’s important to remember that painkillers are supposed to be used temporarily because they can cause long-term side effects. If you’re still in pain several weeks after you’re diagnosed, come back to the clinic. You might need further treatment.
Wearing Supportive Shoes and Orthotics
One of the best things you can do to prevent and recover from heel bursitis is to wear supportive shoes. Avoid footwear with a rigid heel because it puts additional pressure on the inflamed tissues. People whose inflammation is located in the bursa between the Achilles tendon and the heel bone might benefit from special shoes with an Achilles notch that protects the tendon.
On the other hand, patients whose bursitis is located behind the ankle will prefer open-heeled shoes that don’t rub up against their heel. Sometimes, people need heel wedges or orthotics to be able to walk comfortably while they are recovering from bursitis. Ask your doctor before wearing inserts, since you might need to have them custom-made to fit your foot shape.
Certain stretches can lengthen the calf muscles and take pressure off the bursa. When you first get diagnosed with bursitis, we might recommend gently stretching out a tight Achilles tendon. Always stretch continually, and don’t bounce, to prevent placing extra pressure on your body. If your symptoms don’t improve within a few weeks, you might need to see a physical therapist.
They will analyze your gait to determine whether you have any postural issues that could be causing your Achilles pain. Then, they’ll recommend more targeted stretches and strengthening exercises that help you to improve your alignment and recover from your injury. Physical therapists might also be able to recommend the right kind of footwear and orthotics.
Usually, Achilles bursitis is caused by a mechanical problem like shoes that are too tight or an excessive amount of weight-bearing exercise. However, there is a Staphylococcus bacterium that can also cause infection. If you have septic bursitis, antibiotics might be necessary. Typically, oral antibiotics are prescribed, and they might need to be taken for a week. If the infection doesn’t clear up, the patient might have to get an IV.
Corticosteroids are anti-inflammatory drugs, and they are necessary if the patient is suffering from an inflammation that doesn’t get better on its own. The active ingredient of this medicine closely resembles cortisol, a hormone that regulates the body’s immune function and increases the availability of substances that help to repair tissues.
This medication is available in several forms, but it is usually administered as an injection to the treatment site. Sometimes, doctors prescribe a topical steroid cream. Because excessive use of corticosteroids can damage the cartilage in a joint, most patients only receive three or four injections per year.
Aspiration is a minimally invasive treatment that involves removing the excess fluid from the bursa to relieve the pressure on the patient’s heel. It is performed with a needle and a syringe, but no incisions are necessary, and local anesthesia is enough. Sometimes, an ultrasound is used to guide the needle to the right place in the heel joint.
When Is Surgery Necessary?
When none of the above methods work well, and the patient is still suffering from heel bursitis, surgery might be necessary. In this case, the problematic bursa is removed from the body so it can no longer cause pain. A new bursa might grow, and the idea is that it will be less prone to inflammation than the original one.
Sometimes, excess tissue at the back of the heel bone or bone spurs is removed because it could be the cause of the inflammation. After surgery, patients will spend several weeks resting before gradually returning to their former level of physical activity.
Who Is Most at Risk?
People who are very physically active are most at risk because they put a lot of pressure on their heel joints. The likelihood of developing bursitis is high when a patient suddenly increases their activity levels because their body might not be ready for the additional strain placed on it. To prevent problems, always start a new exercise routine gradually.
Certain medical conditions also increase the risk of heel bursitis. People with inflammatory diseases like gout or rheumatoid arthritis and those with a foot or ankle disease are more prone to problems with their bursae.
How to Prevent Heel Bursitis
There are several things you can do to keep your heels and Achilles tendon healthy. Stretch after exercising, always wear supportive shoes, and avoid running on hard surfaces like asphalt. If you have a foot injury, disinfect it immediately, and make sure it doesn’t get dirty. That way, you reduce the risk of Staphylococcus infections that can cause bursitis.
When to Visit the Kelowna, BC or Victoria, BC Clinic
Patients who have heel pain for more than one or two weeks and those who have a medical condition that affects the feet, like diabetes, need to book an appointment with a foot doctor. The expert will examine your feet and take X-rays or even MRI images to find out what is going on inside your joint.
Sometimes, lab tests are necessary to diagnose septic bursitis. Once the doctor knows more about your condition, they come up with a treatment plan, so you can get back to your regular activities as quickly as possible.
There are many nonsurgical treatments for Achilles bursitis. Call us at Island Foot Clinics in Kelowna, BC and Victoria, BC to book your first appointment.