Treatment of Achilles Tendon Bursitis or Tendinitis

About the disease

Achilles bursitis is an inflammatory process, which affects the Achilles tendon, located at the back of the heel. Most commonly, it is manifested as swelling and tenderness in this area, which restricts the walking function of a person. A tender spot at the Achilles tendon is also manifested by redness and by extreme sensitivity, that`s why this condition does not pose difficulty for diagnosis.  

Overall, Achilles tendon is responsible for connecting calf with the heel muscle. This tendon also accounts for mobility of the leg and for ability of a person to run, jump high, and walk long distances. Bursitis develops when fluid-filled sac in the Achilles tendon becomes inflamed and as a result friction in this tendon becomes extremely reduced. Tendon starts to rub over the bones and muscles and start to cause considerable pain to a person.

This disease is more common in women than in men. This condition can be aggravated after a person walked for a long period of time or after there was some kind of pressure on the Achilles tendon. Wearing high-heels and shoes with bad support for the heel can also contribute to development of Achilles bursitis in women who have predisposition to it. Previous injuries and surgeries on the heel can contribute to development of bursitis in future. In 70% Achilles bursitis is caused by constant pressure on the heel.

Symptoms

• Pain in the heel
• Redness
• Tenderness
• Swelling
• Unusual warmth in the heel
• Inability to walk long distances
• Fever in some case

Diagnosis

• During a general examination a doctor will examine the heel of a patient and check for signs of inflammation, as well as signs of redness and stiffness.
• An X-ray of the Achilles tendon can also determine if a person has bursitis, as this imaging test determine if the tendon is inflamed.
• Special imaging tests are sometimes used in people who have inflammatory process of other joints or bones in order to check if the inflammation affected muscles and tissues.

Treatment

• Conservative treatment includes prescription of special corticosteroids, which alleviate the pain in the ankle and reduce the symptoms. These drugs are prescribed in mild form of bursitis but they rarely can fully treat the disease. A special footwear is also prescribed, which help to adjust the patient's feet in a right position, so that pressure on feet is minimal.
• Ankle minimally invasive surgery is used to resect part of the heel, which is inflamed and which can not be treated with regular drugs. This surgery makes a minimally invasive excision and gently removes the fluid-filled sac, which causes pain and inflammation.

Authors: Dr. Nadezhda Ivanisova, Dr. Sergey Pashchenko