FOOT BURSITIS |
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General Information
DEFINITION--Inflammation of one of the bursas in the foot. Bursitis may vary in degree from mild irritation to an abscess formation that causes excruciating pain. The most significant bursas to become inflamed are in the heel bone, the Achilles' tendon where it meets the heel bone, or the joint where the big toe meets the foot.
BODY PARTS INVOLVED
Foot bursas (soft sacs filled with lubricating fluid that facilitate motion in the foot).
Soft tissue surrounding the joints in the foot, including nerves, tendons, ligaments, blood vessels (both large vessels and capillaries), periosteum (the outside lining of bone) and muscles.
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SIGNS & SYMPTOMS
Pain.
Tenderness.
Swelling.
Redness (sometimes) over the affected bursa.
Fever, if infection is present.
Restriction of motion of the foot.
CAUSES
Direct blow or other injury to a foot joint.
Acute or chronic infection.
Arthritis.
Gout.
Unknown (frequently).
RISK INCREASES WITH
Participating in competitive athletics, particularly contact sports such as football, soccer or hockey.
Previous history of bursitis in any joint.
Exposure to cold weather.
Poor conditioning and inadequate warmup.
Inadequate protective equipment in contact sports.
HOW TO PREVENT
Wear well-fitting athletic shoes for contact sports.
Warm up adequately before athletic practice or competition.
Wear warm socks in cold weather.
To prevent recurrence, continue to wear extra protection over the involved bursa in the foot until healing is complete.
WHAT TO EXPECT
APPROPRIATE HEALTH CARE
Doctor's diagnosis and treatment.
Surgery (sometimes), particularly for a frozen foot joint or chronic pain.
DIAGNOSTIC MEASURES
Your own observation of symptoms.
Medical history and physical exam by a doctor.
X-rays of the foot and ankle.
POSSIBLE COMPLICATIONS
Frozen foot joint.
Permanent limitation of the joint's normal mobility.
Prolonged healing time if activity is resumed too soon.
Proneness to repeated flare-ups.
Unstable or arthritic joint following repeated episodes of foot bursitis.
Spontaneous rupture of the bursa if severe infection is present.
PROBABLE OUTCOME
Foot bursitis is a common--but usually not serious -- problem. Symptoms usually subside in 7 to 14 days with treatment if there is no infection present. Infection or the need for surgery may dictate 6 to 8 weeks to heal.
HOW TO TREAT
NOTE -- Follow your doctor's instructions. These instructions are supplemental.
FIRST AIDNone. This problem develops slowly.
CONTINUING CARE
Use frequent ice massage. Fill a large Styrofoam cup with water and freeze. Tear a small amount of foam from the top so ice protrudes. Massage firmly over the injured area in a circle about the size of a softball. Do this for 15 minutes at a time, 3 or 4 times a day, and before workouts or competition.
After 72 hours, apply heat instead of ice, if it feels better. Use heat lamps, hot soaks, hot showers, heating pads, or heat liniments or ointments.
Take whirlpool treatments, if available.
Use crutches to prevent weight-bearing, if needed.
Elevate the foot above the level of the heart to reduce swelling and prevent accumulation of fluid. Use pillows for propping or elevate the foot of the bed.
Gentle massage will frequently provide comfort and decrease swelling.
MEDICATIONYour doctor may prescribe:
Non-steroidal anti-inflammatory drugs.
Antibiotics if the bursa is infected.
Prescription pain relievers for severe pain. Use non-prescription acetaminophen or ibuprofen (available under many trade names) for mild pain.
Injection with a long-lasting local anesthetic mixed with a corticosteroid drug, such as triamcinolone.
ACTIVITYRest the inflamed area as much as possible. If you must resume normal activity immediately, use crutches until the pain becomes more bearable. To prevent a frozen joint, begin normal, slow joint movement as soon as possible.
DIETEat a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk and eggs. Increase fiber and fluid intake to prevent constipation that may result from decreased activity. Your doctor may suggest vitamin and mineral supplements to promote healing.
REHABILITATIONSee section on rehabilitation exercises.
CALL YOUR DOCTOR IF
You have symptoms of foot bursitis.
Pain increases, despite treatment.
Pain, swelling, tenderness, drainage or bleeding increases in the surgical area.
You develop signs of infection (headache, muscle aches, dizziness or a general ill feeling and fever).
New, unexplained symptoms develop. Drugs used in treatment may produce side effects.
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