HEEL BURSITIS

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What is Heel Bursitis?

Heel bursitis is a condition where the bursa, a small fluid-filled sac that serves as a cushion, in the heel becomes inflamed. The bursa helps reduce friction between bones and surrounding tissues, including muscles and tendons. When the bursa in the heel becomes irritated or inflamed, it may cause pain and swelling in the affected area.

Symptoms of Heel Bursitis:

Symptoms of heel bursitis are usually localised to the back or underside of the heel, depending on which bursa is involved. Common signs include:

  1. Pain: Pain is the main symptom, often described as sharp, burning, or aching at the back or bottom of the heel. It typically worsens with standing, walking, or activities such as running and jumping. When the retrocalcaneal bursa (at the back of the heel) is affected, the pain is usually felt just behind the heel.
  2. Swelling: Swelling may develop around the affected area, especially if the inflammation is more severe. This can make the heel tender when touched.
  3. Redness and Warmth: The skin over the affected region may appear red and feel warm, particularly during active inflammation.
  4. Pain with Activity: Discomfort often increases with activities that put pressure on the heel. Walking barefoot on hard surfaces may also be painful.
  5. Stiffness: The heel may feel stiff, particularly after periods of rest, and movement can be restricted or uncomfortable.

Treatment We Offer:

Ultrasound Guided Cortisone Injections

Ultrasound-guided cortisone injections for heel bursitis can be an effective treatment option for relieving pain and inflammation associated with this condition. The use of ultrasound guidance allows precise targeting of the affected bursa, ensuring that the cortisone (corticosteroid) medication is delivered accurately to the site of inflammation, improving the overall effectiveness of the injection.

How Does an Ultrasound-Guided Cortisone Injection Work for Heel Bursitis?

  • Ultrasound Guidance: Ultrasound is used to provide real-time imaging of the heel and the inflamed bursa. The healthcare professional uses the ultrasound to guide the needle accurately into the affected bursa. This ensures that the cortisone injection is delivered directly to the site of inflammation, improving the likelihood of pain relief and reducing the risk of injury to nearby structures such as nerves, tendons, and blood vessels.
  • Cortisone Injection: Cortisone is a potent anti-inflammatory medication that helps reduce inflammation and relieve pain. The injection of cortisone into the bursa works by decreasing swelling and irritation, providing significant relief from discomfort. In some cases, local anaesthetics are also used in combination with the cortisone to provide immediate pain relief and help manage discomfort from the injection itself.

  • Benefits of Ultrasound-Guided Cortisone Injection for Heel Bursitis:

    1. Accurate Targeting: Ultrasound guidance ensures that the needle is placed precisely in the affected bursa, increasing the likelihood of successful treatment and reducing the risk of complications.

    2. Quick Pain Relief: The cortisone injection can provide quick relief by reducing the inflammation in the bursa. Patients often experience reduced pain and swelling within a few days of the injection.

    3. Minimal Risk: Using ultrasound guidance allows for real-time monitoring, minimizing the risk of hitting nearby structures (like tendons or nerves). It also reduces the risk of injecting the medication into the wrong area.

    4. Reduced Need for Oral Medications: Since the cortisone is injected directly into the inflamed area, there is less reliance on oral anti-inflammatory medications, which can have side effects like gastrointestinal issues or kidney problems when used long-term.

    5. Non-Surgical Option: This procedure is non-invasive and provides a conservative treatment option to avoid surgery.

    When Is Ultrasound-Guided Cortisone Injection Recommended?

    Ultrasound-guided cortisone injections are typically considered when conservative treatments, such as rest, ice, NSAIDs, and physical therapy, have not provided adequate relief for heel bursitis. It may be used for:

    • Chronic Heel Bursitis: When heel bursitis persists over time and causes ongoing pain, cortisone injections can help reduce inflammation and provide relief.

    • Severe Pain: If the pain from heel bursitis is severe and affects daily activities, a cortisone injection can offer fast relief and improve quality of life.

    • Limited Function: When bursitis limits mobility, walking, or participation in sports, a cortisone injection may be necessary to reduce pain and restore function.

Your Care Pathway with us

  1. To book an appointment you can call our reception line, 0142084487, or email to info@altonpainclinic.co.uk or click the button given below.
  2. Comprehensive Musculoskeletal examination and testing.
  3. Same day Ultrasound Guided Injection for pain relief.
  4. Discussion of your treatment plan, treatment plan can include advanced treatments for example  Cortisone Injections, Hyaluronic injections and various other options tailored to your specific needs.
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Understanding Bursitis

Heel bursitis is a condition in which the bursa (a small fluid-filled sac that acts as a cushion) in the heel becomes inflamed. The bursa is designed to reduce friction between bones and surrounding tissues, such as muscles and tendons. When the bursa in the heel becomes irritated or inflamed, it can cause pain and swelling in the affected area.

What Causes Heel Bursitis?

Heel bursitis typically occurs due to repeated friction, pressure, or stress on the heel. The most common cause of this condition is overuse or irritation of the bursa from activities that involve a lot of foot pressure, impact, or repetitive movements. Here are some of the primary causes of heel bursitis:

  1. Excessive Pressure on the Heel:

    • Wearing ill-fitting shoes that put pressure on the heel.
    • Walking, running, or standing for long periods on hard surfaces.
    • Repetitive activities such as running, especially on hard surfaces like concrete, which can increase pressure on the heel.

  2. Injury or Trauma:

    • A direct blow to the heel, such as from a fall or sports injury, can irritate the bursa and lead to bursitis.
    • Overuse injuries in athletes, particularly those involved in running or jumping sports, can stress the heel and cause inflammation in the bursa.

  3. Poor Foot Mechanics:

    • Conditions such as flat feet, high arches, or abnormal gait patterns can cause increased pressure on certain areas of the foot, leading to inflammation of the bursa.

  4. Other Medical Conditions:

    • Conditions like rheumatoid arthritis, gout, or infection can make the bursa more susceptible to inflammation.
    • Obesity or being overweight can increase pressure on the feet and contribute to the development of heel bursitis.

  5. Age and Lifestyle Factors:

    • As we age, the cushioning effect of the fat pad on the heel may decrease, leading to increased pressure on the heel bursa. This may make the heel more susceptible to bursitis.
    • People who are less active or have sedentary lifestyles may be more likely to develop heel problems due to weak muscles and poor foot support.

Symptoms of Heel Bursitis:

The symptoms of heel bursitis are generally localized around the back or bottom of the heel, depending on the type of bursa affected. Common symptoms include:

  1. Pain: Pain is the hallmark symptom, often felt as a sharp, burning, or aching pain at the back or bottom of the heel. The pain is usually worse when standing, walking, or engaging in activities like running or jumping.

    • If the retrocalcaneal bursa (located at the back of the heel) is affected, the pain is usually felt just behind the heel.
    • If the subcutaneous calcaneal bursa (located at the bottom of the heel) is involved, the pain may be felt more at the underside of the heel.

  2. Swelling: Swelling may appear near the affected area, particularly if the inflammation is severe. This swelling can make the heel feel tender to the touch.

  3. Redness and Warmth: The skin around the affected area may become red and warm to the touch, particularly if there is an active inflammatory process.

  4. Pain with Activity: The pain often worsens with certain activities, especially those that place pressure on the heel. It may also be painful to walk barefoot on hard surfaces.

  5. Stiffness: The heel may feel stiff, especially after rest, and movement may be limited or uncomfortable.

Types of Heel Bursitis:

There are two main types of heel bursitis, depending on the location of the affected bursa:

  1. Retrocalcaneal Bursitis:
    • This is the most common type of heel bursitis and involves inflammation of the bursa located at the back of the heel, between the Achilles tendon and the heel bone (calcaneus).
    • It is often associated with activities that involve excessive pressure on the back of the heel, such as running or wearing shoes with a tight heel counter.
  2. Subcutaneous Calcaneal Bursitis:
    • This type of bursitis occurs when the bursa located beneath the heel bone becomes inflamed. The subcutaneous calcaneal bursa helps reduce friction between the heel bone and the overlying skin.
    • It can be caused by excessive pressure from standing or walking on hard surfaces or by activities that cause constant impact on the heel, like running.

Diagnosis of Heel Bursitis:

To diagnose heel bursitis, a healthcare provider will typically start by reviewing your medical history and conducting a physical exam. They may also ask questions about your activity level, footwear, and symptoms.

  1. Physical Examination: The doctor will check for tenderness, swelling, and warmth in the heel area. They may also ask you to move your foot to assess pain and stiffness.

  2. Imaging Tests: In some cases, imaging tests such as X-rays or ultrasound may be used to rule out other conditions like fractures, tendonitis, or bone spurs. An MRI might also be ordered to get a detailed image of the soft tissues and confirm the presence of bursitis.

Prevention of Heel Bursitis:

To prevent heel bursitis from occurring or recurring, consider the following steps:

  1. Wear Proper Footwear: Choose shoes that provide good arch support, cushioning, and a proper fit. Avoid shoes that put pressure on the back of the heel.

  2. Avoid Overuse: If you’re involved in activities that stress the heel (like running or jumping), try to balance these activities with rest days to give your body time to recover.

  3. Stretch Regularly: Stretch your calves, Achilles tendon, and the bottom of your feet to prevent tightness and reduce the risk of bursitis.

  4. Use Orthotic Inserts: Custom or over-the-counter orthotic insoles can provide additional support and cushioning to reduce heel pressure.

  5. Maintain a Healthy Weight: Excess weight can place additional pressure on the feet, increasing the risk of heel problems. Maintaining a healthy weight helps reduce strain on the joints and soft tissues.

Conclusion:

Heel bursitis is an inflammatory condition that causes pain and swelling in the heel due to irritation or inflammation of the bursa. It is commonly caused by overuse, pressure, or trauma and can significantly affect daily activities. With proper treatment, including rest, ice, proper footwear, and physical therapy, most people with heel bursitis can recover fully and return to their regular activities. If conservative treatments don’t work, more advanced options such as corticosteroid injections or surgery may be considered.

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