Heel bursitis: symptoms, treatment with medications and folk methods

Bursitis

is an inflammatory disease that occurs in the synovial bursa of the joint and is associated with the accumulation of fluid in the joint cavity.
Bursitis can occur in all 180 joints of the human body
, from the smallest to the largest, partially or completely limiting movement in them.

This disease is just a defensive reaction of the body, which is trying to protect the injured lining of the joint capsule from further destruction. Indeed, rest is necessary to cure bursitis, because sometimes (for example, with an injury), it gives the joint time to heal and recover, and with it the inflammation goes away. But acute bursitis can cause irreparable damage to the joint and lead to the formation of adhesions on the synovial cartilage

. And if left untreated, it can cause purulent arthritis of the joint, osteomyelitis, spread of infection throughout the body, or persistent limitation of joint mobility.

Like most diseases, bursitis can be completely cured in the early stages. But how to recognize it in time? How to treat bursitis? We will tell you who is at risk, how to prevent the disease and how to avoid complications.

Bursitis is a disease in which the joints become inflamed.

Causes of bursitis

The leading triggers of bursitis include injury or overload, infection in the joint capsule or the formation of metabolic crystals in it in some chronic diseases.

Inflammation can be caused by, among other things:

• even minor damage to soft tissue in the periarticular area (cut, bruise, abrasion, muscle sprain, ligaments or tendons), especially if it is accompanied by hemorrhage into the joint capsule;
• inflammatory process near the joint - for example, in the subcutaneous tissue (phlegmon), epidermis (carbuncle, furuncle), medullary canal (osteomyelitis);
• generalized or focal chronic infection (for example, tonsillitis, caries, nasopharyngitis, genitourinary, intestinal, respiratory infections, pyogenic processes occurring in any organ;
• deposition of crystals in the joint capsule (for example, uric acid - in gout);
• monotonous static and dynamic physical activity of any intensity (from carrying loads to working with vibrating tools, exhausting housework or prolonged standing);
• physical overload and failure to comply with safety precautions when performing sports exercises;
• unfavorable working conditions (for example, the need to hold their hands above their heads for a long time puts painters at risk for shoulder bursitis);
• overweight;
• chronic diseases associated with metabolic disorders (diabetes mellitus, chronic alcoholism, gout, obesity, adrenoleukodystrophy, AIDS, liver and kidney diseases);
• autoimmune diseases (rheumatoid arthritis, systemic lupus erythematosus, scleroderma);
• taking certain hormonal medications and age-related changes in hormonal levels;
• acute intoxication;
• increased allergic sensitivity;
• exposure to temperature factors (for example, overheating or hypothermia);
• incorrect posture;
• history of bursitis, as well as other diseases of the musculoskeletal system.

Those at risk for bursitis include:

• athletes (cyclists, parkour athletes, golfers, gymnasts) and people engaged in heavy physical labor;
• persons infected with staphylococci, streptococci, gonococci, pneumococci, patients with tuberculosis or brucellosis, as well as other chronic infections;
• allergy sufferers;
• patients who have had infectious diseases or have weakened immunity for other reasons;
• elderly people.

What could be the reason?

Most often, damage or heavy load is necessary for the disease to develop. Less commonly, the disease is part of a symptom complex of another, more serious pathology. Therefore the main reasons are:

• Trauma (bruise, awkward movement)
• Physical overload
• Friction (for example, constant support on the elbow (with inflammation of the olecranon bursa) or moving on all fours with damage to the patella
• Some rheumatological diseases (gout, ankylosing spondylitis)

Sometimes the cause cannot be determined.

Classification of bursitis disease

As a disease, bursitis is usually divided into:

• specifics of the course
  (acute, subacute, chronic or recurrent);
• pathogen
  (specific or nonspecific infections, inflammation without an infectious pathogen), as well as origin (primary or secondary bursitis);
• type of exudate
  (serous, purulent, hemorrhagic)
• localization
  .

Bursitis with a sudden onset and acute course can be completely cured if therapy is started early. If a visit to the doctor is constantly postponed or his recommendations are not followed, the transition to a chronic form is most likely

- in this case, the disease lasts several months, and subsequently recurs, causing irreparable consequences.

As a primary disease, bursitis occurs with direct damage to the joint capsule or local infection. Secondary - as a consequence of another chronic disease. The type of exudate can be determined only after taking a sample - based on it, treatment will be selected.

conclusions

1. Heel bursitis is an inflammation in the synovial bursa (bursa) caused by mechanical stress or infection.
2. Knowing the symptoms of the disease and promptly consulting a doctor, the disease can be detected in the early stages. Only timely and correctly selected treatment will help get rid of the disease , which negatively affects the quality of life.
3. Treatment of bursitis at home includes compresses, heating, the use of tinctures and foot baths.
4. Folk remedies can be used only after consultation with a doctor , which will help avoid negative reactions of the body, in particular allergic reactions.
5. Traditional recipes cannot replace traditional treatment prescribed by a doctor. They can be an auxiliary or prophylactic agent to the main treatment.

Symptoms of bursitis

Acute bursitis usually begins suddenly and is accompanied by:

• sharp pain that intensifies with movement, as well as pricking or shooting pains at night;
• soreness and hypersensitivity of the skin over the joint;
• limitation of mobility in the joint;
• hyperemia and swelling of the skin over the joint;
• local or general increase in temperature;
• weakening of muscles;
• when palpating the joint, you can detect a non-rigid seal filled with liquid, which resembles a balloon filled with water to the touch;

Most often, symptoms of bursitis appear in the shoulders

,
knee
,
elbow and hip joints
, as well as
joints in the area of ​​the heel tendon
. Symptoms and treatment of bursitis depend on the intensity of the inflammation. If left untreated, the increase in body temperature can reach 40°C due to a purulent process. At this stage, there is a high probability of complications - for example, erysipelas, subcutaneous fat tissue suppuration.

Symptoms of chronic bursitis are that:

• pain becomes moderate, tolerable or absent altogether;
• the infused seal under the skin remains for a long time;
• movements are less constrained or there is no restriction on their amplitude at all.

The recurrent process is characterized by a combination of all the symptoms of bursitis: the chronic course is periodically interspersed with exacerbations of symptoms. If this condition is not treated

,
subsequently fistulas begin to form
,
which create the risk of purulent arthritis
.

Fluid accumulation in the joint cavity is a common symptom of bursitis.

Bursitis of the knee joint

In the projection of the patella (kneecap), swelling, moderate pain, and less commonly, redness appear. There are several bursae - prepatellar, infrapatellar, etc. Depending on which of them is inflamed, the symptoms may differ in location and severity. With prepatellar bursitis, there is swelling immediately above the patella (photo below), there is practically no swelling, pain, or redness of the skin. In the case of infrapatellar inflammation, on the contrary, pain predominates.

Diagnosis of bursitis

Some specialists diagnose bursitis only based on a survey and physical examination of the patient. During oral data collection, the doctor clarifies the presence of injuries, diseases, recent infections, overuse, as well as specific symptoms of bursitis and a list of medications taken (some blood thinners can cause bleeding in the joint).

However, to confidently differentiate the disease, bursitis from synovitis and other similar pathologies, the doctor may prescribe standard procedures: x-ray examination

or
ultrasound of the affected joint
. If the clinical picture is blurred (for example, by the chronic course of the disease, taking anti-inflammatory drugs and analgesics, concomitant diseases), additional studies may be needed. Less commonly, computer or magnetic resonance imaging of the diseased joint is prescribed.

To determine the causes of bursitis, you may need to:

• biochemical examination of blood and urine;
• serological tests for the presence of antibodies to infections;
• study of biomaterial using PCR to determine the pathogen;
• puncture (fluid sampling) of the joint capsule to determine the microorganisms involved in the inflammatory process, as well as their sensitivity to antibacterial agents.

The combination of various research methods eliminates inaccurate diagnosis and helps the doctor reliably determine how to treat bursitis.

Main symptoms

The development of bursitis is indicated by the pain that a person feels in the heel area. The pain is similar to a heel spur, but it is not as severe. Pathology is also indicated by the appearance of a tubercle on the heel, a compaction with a soft consistency. Movement of the foot during the development of heel bursitis causes discomfort. In most cases, the symptoms of heel bursitis are noticeable in the morning: the heel area is swollen, swelling appears, and redness of the skin appears . If left untreated, there may be a complication of the disease such as rupture of the heel tendon, which leads to loss of foot function and disability.

Treatment of bursitis

In most cases, bursitis requires conservative treatment for 2-5 weeks; surgical intervention is indicated only in particularly advanced cases or with the development of purulent bursitis.

In addition to taking medications in accordance with the doctor’s recommendations, the patient is recommended physiotherapeutic procedures to relieve inflammation, as well as complete rest. To relieve stress on the joint, you can use plaster splints or walking aids.

With a mild inflammatory process, treatment of bursitis is carried out at home and includes rest, wearing an elastic bandage, applying compresses with decongestant and anti-inflammatory compounds.

You can use an ice compress before visiting an orthopedist or rheumatologist.

to relieve swelling and tenderness, or
cooling ointments
as a temporary measure to relieve the symptoms of bursitis. For this purpose, ice is applied to the sore joint for 5-15 minutes every 4-6 hours.

Surgical treatment of bursitis

In cases where the seal over the joint is too large and the process of its resorption will take too long, the doctor may decide to perform a minimally invasive operation - puncture

or
drainage
to drain excess fluid. The puncture can be combined with arthroscopic lavage - a procedure in which disinfectant solutions are injected into the joint capsule, and then they are removed back and an intra-articular injection of a steroidal anti-inflammatory drug is performed.

Also, surgical treatment of bursitis is indicated for suppuration in the cavity of the joint capsule, the formation of articular adhesions that interfere with normal mobility in the joint. In case of severe purulent inflammation and the settling of a diseased amount of crystals on the lining of the joint capsule, arthrotomy (opening of the joint cavity) may be necessary. It is performed through a small incision (up to 1 cm) with the removal of dead tissue, metabolites, calcium deposits on tendons and other foreign objects, which allows you to quickly and reliably relieve the patient’s condition even with severe acute and chronic bursitis.

In case of phlegmon, fistulas, and also when conservative treatment of bursitis is ineffective, tissue excision is performed - bursectomy or other types of ectomy.

As a rule, pain goes away immediately after surgery.

,
mobility in the joint is restored after a few days
,
and sutures are removed 10 days
after the intervention.

Physiotherapy in the treatment of bursitis

Physiotherapy in the treatment of bursitis is indicated in cases where medications are not enough to quickly and completely stop the inflammatory response. Physiotherapeutic techniques for the treatment of joint bursitis can normalize the metabolic process in the affected tissues, relieve swelling and pain, and affect the inflamed area at the cellular level. They enhance the effect of medications and help achieve drug-free remission in chronic bursitis. The following procedures are most effective:

• magnetic therapy;
• shock wave therapy;
• balneotherapy;
• cryotherapy;
• medicinal electrophoresis (usually with novocaine);
• UV irradiation;
• paraffin applications, ozokerite;
• kinesiotherapy (only in remission);
• massage (only in remission).

They allow you to restore mobility in the joint and prevent relapses and complications.

Exercise therapy in the treatment of bursitis

Therapeutic exercises for bursitis are indicated purely as a means of rehabilitation and prevention of relapses. It is strictly forbidden to perform any exercises during an exacerbation of the disease.

. The presence or absence of inflammation must be determined by a traumatologist or orthopedist.

The choice of exercises for the treatment of bursitis is determined primarily by the localization of the disease in a particular joint, the presence of complications and the purpose of performing gymnastics. As a rule, standard sets of exercises are used to restore mobility in the joint. Conventionally, the exercises in them can be grouped as follows:

• gentle stretching of muscles and extension of the joint manually;
• flexion-extension of the joint;
• rotation in the joint;
• general strengthening of the muscles of the limb (for example, lifting);
• overcoming additional resistance during flexion-extension.

The load when performing exercises should be increased gradually. If you experience the slightest pain in a joint, you must stop exercising immediately!

Therapeutic gymnastics - a means of rehabilitation after illness

Effective treatments at home

Treatment of heel bursitis requires strict adherence to the doctor’s instructions. This will eliminate the problem in the early stages, prevent relapses and transition to a chronic form. There are several types of procedures that are used for heel bursitis. All of them have proven effective as an auxiliary treatment and prevention for this disease, which affects the fair sex, who often wear high-heeled shoes, as well as people involved in active sports.

Compresses

Here are some effective recipes:

1. Fresh burdock or cabbage leaves can relieve inflammation . You need to take a clean sheet of one or another product and apply it to the area damaged by bursitis. A wool bandage is required on top. The compress needs to be changed after 6 hours. Repeat until swelling decreases;
2. For a vinegar-honey compress, you need to take natural honey and vinegar (table or apple) in equal proportions. Mix the components thoroughly and distribute evenly on a gauze napkin. Apply to the affected area overnight, tying it with a scarf;
3. Compress made from laundry soap, onion and honey . This remedy has proven its effectiveness in the treatment of bursitis when the disease is already advanced and has become chronic. You need to take 1 teaspoon of soap shavings, onion gruel, honey. Melt the honey and soap in a water bath and distribute evenly on a gauze napkin, with onion pulp on top (in a meat grinder or finely chopped). Apply a compress to the affected area overnight, wrapped in a warm scarf. The course of treatment is 2 weeks.

Applying a compress to the affected area helps reduce swelling and relieve inflammation. If you follow the technology, you can briefly reduce pain, which is extremely important in acute forms.

You can find out which doctor treats hip bursitis in this article.

Foot baths

Warm foot baths will help relieve joint pain:

1. Fir oil . Add a few drops of fir oil to a bowl of warm water. Immerse the foot affected by bursitis in water for 15-20 minutes;
2. Sea salt . Baths with the addition of this product normalize metabolic processes and quickly relieve the inflammatory process. Foot bath time: 20 minutes;
3. Needles . The needles need to be soaked in cold water and then boiled. Soak the sore leg for 30 minutes, the water should be such that it can be tolerated;
4. Hay dust . 2-3 tbsp. Pour cold water over hay dust, bring to a boil and boil for 30 minutes. Add to warm water. Immerse the sore leg in the bath for 5-10 minutes.

Foot baths also help improve the condition of the skin of the feet, as the blood supply to the tissues improves. Regular use of baths also eliminates dry feet.

Tinctures

Tinctures can also have a beneficial effect on heel bursitis:

1. Honey and vinegar . For cooking you will need 1 tbsp. boiled water, which needs to be cooled, 1 teaspoon of vinegar (apple vinegar is better) and 1 teaspoon of honey. Mix all ingredients. Drink 250-500 ml per day for 3 weeks;
2. Celery . 1 tbsp. l celery seeds pour 1 tbsp. boiled water. Leave for 1.5 hours, then strain. Drink as tea 2 times a day. Course of treatment – ​​2 weeks;
3. Birch, nettle violet . 1 tbsp. pour 1 liter of boiling water over a mixture of birch leaves, nettles and violets. Let it brew, then strain. Drink 100 ml half an hour before meals, 5-6 times a day.

For heel bursitis, it is also recommended to drink freshly squeezed grapefruit juice - this allows you to replenish the supply of vitamin C, which is necessary to strengthen the immune system.

Warming up

Applying heat to the affected area can reduce pain and reduce inflammation. Warming is the simplest and most effective method of treating bursitis at home. Several recipes:

1. Salt . Pour salt into a linen bag, which should be heated in a dry frying pan. Apply the bag to the affected area. Do it daily for two weeks;
2. Flaxseeds . Heat the flax seeds in a frying pan, as in the case of salt, pour them into a linen bag and apply to the sore spot. It is recommended to do it at night every day. Course – 2 weeks;
3. Granulated sugar . Heat in a dry frying pan (the sugar should not melt). Take a bag made of thick fabric and pour heated sugar into it. Place the bag on the area affected by bursitis, place a plastic bag on top of it and tie it with a warm scarf. Do this compress every night at night until the swelling goes away.

The effectiveness of treatment increases if you combine folk remedies, for example, baths and compresses, baths and tinctures.

Drug treatment of bursitis

The choice of medication for bursitis depends on the results of a synovial fluid test. If its composition is normal and does not contain dead leukocytes and infectious pathogens, anti-inflammatory therapy with nonsteroidal and steroidal drugs is carried out. If the analysis reveals infectious agents, an individual antimicrobial treatment program is drawn up based on the antibioticogram.

Anti-inflammatory drugs

Non-steroidal anti-inflammatory drugs are used as the main medications for bursitis. When the inflammatory process is mild, NSAIDs are prescribed topically, in other cases - systemically (in the form of tablets or injections) or in combination with each other.

A severe inflammatory process, which is accompanied by severe pain and cannot be controlled with non-steroidal drugs for bursitis, requires the use of hormonal agents - glucocorticoids (GC). They are usually injected directly into the joint capsule after it has been washed; less often - used for intramuscular or intravenous administration.

If the inflammatory process subsides before taking medications for bursitis, doctors predict a successful cure for the disease without restricting mobility in the future

.

Both NSAIDs and GCs have side effects, so you should consult your doctor for an individual prescription before using them. Do not use NSAIDs for erosive and inflammatory lesions of the mucous membranes of the stomach and intestines.

In addition to anti-inflammatory drugs, regular analgesics can be used after visiting a doctor.

The following NSAIDs are used for bursitis: Naproxen

,
Meloxicam
,
Nimesil
,

And also GK: Diprospan

,
Glucocortisone
,
Prednisolone
,
Methylprednisolone
,
Dexamethasone
,
Triamcinolone
.

Antimicrobials and antibiotics

Before conducting a serological test or PCR, the doctor may prescribe broad-spectrum antibiotics. If the patient suffers from the consequences of a specific infection, the doctor chooses a medicine for bursitis that is most effective against this pathogen.

Broad spectrum antibiotics: Doxycycline

,
Tetracycline
,
Rondomycin
,
Ceftriaxone
,
Blicef
,
Ofloxacin
,
Ciprofloxacin
,
Floxal
and others.

Chondroprotectors

As a preventive measure, as well as in case of damage to the synovial bursa, it is recommended to take chondroprotective agents - glucosamine and chondroitin sulfate. They help restore damaged cartilage tissue, strengthen ligaments and tendons, and make the bursa more resistant to stress. This is the only group of drugs that improves the architecture of the joints, promotes the healing of erosive lesions without the formation of adhesions, which impair mobility in the joint affected by bursitis.

It is especially important to take chondroprotectors in case of chronic or recurrent bursitis, as well as in severe cases with purulent complications

.

Long-term use of chondroprotectors improves the quality of synovial fluid, which is a source of nutrients for the entire joint, helps to achieve remission without the use of NSAIDs and GCs and without side effects.

Chondroprotectors are produced in the form of capsules, tablets, injections and ointments. The drug Artracam in a sachet is especially easy to use; it has a pleasant sweetish-lemon taste - it can be diluted in water, and the bioavailability of glucosamine reaches 90-95%. A sachet with a daily dose is convenient to take with you to work.

Other chondroprotectors: Artra

,
Dona
,
Alflutop
,
Chondroitin Complex
,
Movex Active
,
Structum
.

There are several types of drug treatment for bursitis.

Cooling and anti-inflammatory ointments

With a mild course of the disease, external remedies - gels, creams, ointments, balms and compresses - are sometimes enough to cure. In other cases, they are an auxiliary measure that alleviates discomfort in the joint for the patient, reduces pain and swelling. In most cases, drugs for external use provide only a symptomatic effect and do not solve the problem.

.

Ointments for bursitis: Indomethacin

,
Diclofenac
,
Vishnevsky ointment
,
Nayatox
,
Apizartron
,
Ibuprofen
,
Voltaren
,
Ortofen
,
Finalgel
,
Ichthyol
,
Dolobene
,
Capsicam
,
Ungapiven
.

Dimexide are also recommended as an external decongestant.

.
In the presence of hemorrhages and hematomas, it is worth adding Heparin
.

Contraindications

Every person should understand that any folk remedy not only has valuable components that have a beneficial effect on the body, but can also cause harm. First of all, this is the possibility of an allergic reaction of the body to some component. This is why it is so important to check each remedy with your doctor, rather than starting a heel bursitis treatment with honey, salt or vinegar because it helped a friend or colleague at work. If a skin rash, redness or swelling appears, you should refuse further treatment and consult your doctor.

You can read about the treatment of knee bursitis with medications in this material.

Reasons for the development of heel bursitis

Wrong shoes can cause heel bursitis

The causes of heel bursitis can be divided into two groups – mechanical and articular. Mechanical causes of the development of the disease include any traumatic effects and heavy loads on the heel, as a result of which the bursa is compressed or the normal flow of synovial fluid is disrupted. Heel bursitis can be a consequence of:

• wearing uncomfortable shoes;
• injuries;
• prolonged load on the feet;
• features of professional activity;
• intense loads in athletes;
• overweight.

Heel bursitis due to uncomfortable shoes is a common pathology among women. High-heeled dress shoes disrupt normal blood flow in the foot and change the distribution of stress on the toes and heel. If, in addition, the shoes are too narrow and made of materials that impede the supply of oxygen to the skin, the feet quickly swell, local trophism is disrupted and the risk of developing bursitis increases many times over.

Quite often, inflammation appears after an injury. A characteristic feature of post-traumatic bursitis is a slow increase in symptoms. It may take several weeks from the moment of injury to the appearance of swelling around the bursa.

People whose professional activities involve prolonged stress on their feet often develop heel bursitis. Shoes also play a decisive role here, since poor-quality and uncomfortable shoes provoke disruption of local metabolic processes when walking for a long time.

Interestingly, wearing narrow high-heeled shoes more often causes inflammation of the bursa near the big toe, but heel bursitis is experienced mainly by women who prefer flat-soled shoes, such as ballet flats or sneakers. Comfortable shoes with a moderate rise and a heel no larger than 5 cm help maintain foot health.

Heel bursitis is a common disease among professional athletes. Both track and field athletes and weightlifters encounter it equally often.

Another unobvious factor that greatly increases the risk of developing this pathology is the presence of excess weight. The fact is that with excess body weight, the spine suffers greatly while walking. This leads to incorrect distribution of the load on the lower limbs, since one leg of a person is always slightly stronger. As a result, one foot will experience heavy loads when walking, which greatly increases the rate of wear of the joints, loss of elasticity of the cartilage and leads to inflammation in the synovial bursa.

Heel bursitis can develop against the background of the following pathologies of the musculoskeletal system:

• flat feet;
• scoliosis or kyphosis;
• valgus deformity of the foot and big toe;
• gouty arthritis of the feet;
• rheumatoid arthritis.

In these cases, the development of the disease is due to improper distribution of the load on the feet.

Chronic diseases that increase the risk of developing the disease are diabetes, varicose veins, and osteomyelitis.

Against the background of these pathologies, normal blood circulation in the lower extremities is disrupted. This can lead to the formation of wounds, ulcers, boils and fistulas, through which the infection enters the joint cavity or joint capsule, causing an inflammatory process.

Diagnostics

The diagnosis is made quickly; an experienced doctor only needs to examine the patient. Achilles bursitis is characterized by pronounced visual changes in the affected area, so you can notice it yourself.

Additionally, the patient needs to have an X-ray to exclude pathologies of the joints and bones, and an MRI to visualize the condition of the soft tissues around the heel. A puncture may also be indicated - a puncture of the bag to collect a small amount of exudate for analysis. This allows you to study the composition of the exudate if infectious bursitis is suspected.

Types of bursitis

Changes in the composition of synovial fluid affect the types of heel bursitis

According to the localization of the inflammatory process, heel bursitis is of two types - inflammation of the plantar fascia (heel bursitis) and inflammation in the Achilles tendon, more precisely, at the junction of the tendon with the heel bone. Both types of disease occur equally often and are collectively called heel bursitis.

According to the nature of the disease, bursitis can be acute or chronic. Acute bursitis is a primary inflammation in the joint capsule. Its symptoms are pronounced and increase rapidly. Without treatment, the disease slowly declines and becomes chronic. Its symptoms are quite vague; bursitis is often indicated by only a slight swelling, but any injury or compression of the bursa leads to severe discomfort.

According to the nature of the inflammatory process, bursitis can be infectious or aseptic. Aseptic inflammation is manifested by the absence of changes in the composition of the synovial fluid. This inflammatory process is not associated with infection of the bursa, but with a violation of the trophism of the synovial fluid. Because of this, its amount in the bag increases, swelling forms, and due to increased pressure inside the bag, an inflammatory process occurs.

Infectious bursitis is a disease manifested by changes in the composition of the synovial fluid. Analysis of exudate from the bursa shows the presence of pathogenic microorganisms. According to the type of pathogen, infectious inflammation can be:

• purulent;
• gonorrheal;
• tuberculosis.

Purulent bursitis is usually caused by opportunistic microorganisms, such as staphylococcus or streptococcus. Pathogenic agents penetrate into the bursa through the bloodstream, or due to mechanical damage and infection of the wound. Often the cause of purulent inflammation is boils on the feet. The pathology is characterized by the formation of a dense abscess on the heel, which hurts when putting pressure on the foot.

Gonorrheal inflammation in the bursa is observed against the background of gonorrhea infection. The disease has the same symptoms as non-infectious bursitis, but pathogenic bacteria are found in the analysis of synovial fluid.

Tuberculous bursitis develops exclusively against the background of tuberculosis. The infection penetrates the bursa through the bloodstream. This form of the disease is very dangerous, since without treatment, Koch's bacillus can affect the joints and tissues around them.

Based on the nature of changes in the composition of synovial fluid, fibrous and hemorrhagic bursitis are also distinguished. With such inflammation, protein compounds or inclusions of blood are found in the bag.

Surgery

Long-term rehabilitation is required after surgery

Surgical treatment is indicated for purulent bursitis and abscess, but can be prescribed for severe forms of non-infectious inflammation. The doctor opens the inflamed cavity, cleans it and applies antibacterial ointment. The entire procedure takes little time, however, after surgery, additional drug treatment is prescribed and long-term rehabilitation is necessary.