Achilles bursitis - what is this disease and how to cope with it

Achilles bursitis (ICD-10 code – M76.6) is an inflammatory lesion of the Achilles tendon bursa, accompanied by the occurrence of unpleasant pain symptoms in the patient. Pain tends to intensify with any load, which leads to a decrease in a person’s motor activity and a change in gait. Diagnosis is based on an external examination of the patient, as well as the use of additional research methods, both laboratory and instrumental. The disease requires long-term treatment using drug and non-drug approaches.

Classification of the disease

Since Achilles bursitis is an inflammation, any inflammation can be either acute or chronic. Both forms have different symptoms, but similarities can be found.

Acute achillobursitis

The etiology of acute inflammation is an infectious process or other factors.

The onset of the disease is always acute. The patient feels sharp pain and discomfort in the heel area.

Despite the difficult few days, the acute process is easily treated. Having acute Achilles bursitis, treatment with kinesio taping will give excellent results and help avoid severe pain, as it will fix the foot in the correct position.

Chronic achillobursitis

The cause of this disease is an existing infection in the body. The one that is localized in the lower extremities is especially dangerous. Symptoms of a chronic process are not as pronounced as in an acute one. There is a slight increase in the size of the joint and redness of the skin around it. The pain is either mild or completely absent.

Clinical manifestations

In acute cases of achillobursitis or exacerbation of the chronic form of the disease, patients experience characteristic symptoms:

• pain on the back of the leg, localized closer to the heel; with any physical activity the intensity of the pain increases;
• in the area of ​​the heel bone there is swelling of the soft tissues and redness of the skin;
• when pressing on the Achilles tendon, the pain increases significantly;
• the tendon becomes thicker and swollen.

In addition to the local manifestations that are noticeable in the photo of Achilles bursitis, patients also experience general symptoms of intoxication associated with the development of a pronounced inflammatory reaction: increased body temperature, general weakness, muscle and headache.

On a note!

The chronic version of the disease during the period of remission either does not manifest clinical signs at all, or the patient experiences minor pain during physical activity, which goes away after its cessation.

Symptoms of the disease

Symptoms of Achilles bursitis are divided into objective and subjective.

Subjective symptoms may be felt primarily as pain in the heel area. For some, Achilles bursitis is associated with a blow to the leg. Any complaint made by the patient should alert the doctor. In the future, he is obliged to conduct additional research. Objective signs include:

• diffuse pain that spreads from the heel and can reach the knee joint along the line of the calf muscle;
• a slight increase in the size of the joint and redness of the skin around it;
• painful sensations in the joint after a long period of inactivity (sleep or rest) or when jumping;
• limited movements in the ankle joint.

Achilles bursitis can appear on one leg or on both legs at once. Treatment is required depending on the severity of symptoms.

Diagnosis of the disease

Diagnostic measures for achillobursitis of the calcaneus are always carried out according to the following algorithm:

1. The doctor needs to find out all the patient’s complaints, find out details about sports, professional activities, and the presence of concomitant diseases.
2. A blood test reveals leukocytosis (an increase in the number of white blood cells) and an increase in ESR (erythrocyte sedimentation rate). These changes indicate the development of an inflammatory process in the synovial bursa.
3. During a biochemical blood test, an increase in inflammatory markers is noted: fibrinogen, C-reactive protein, etc.
4. A targeted x-ray of the tendon area allows us to exclude traumatic injuries to bone formations, with fractures of which similar clinical symptoms may appear.
5. Ultrasound diagnosis of the ankle joint is necessary to assess the severity of the inflammatory process in the Achilles area.
6. In difficult diagnostic situations, it is possible to perform a puncture of the synovial bursa with cytological and biochemical examination of the inflammatory fluid.

Reasons for the development of the disease

Achilles bursitis has a polyetiological origin. However, after experiments it was proven that the main reasons are increased load on the lower limbs and incorrect foot placement while walking. Examples include the following situations:

• Increased physical activity of the muscles, which is observed after jogging or climbing an elevated surface (mountain or stairs);
• Shoes that are not chosen to fit the size or shape of the foot;
• High heel or platform (a sudden change from a high heel to a flat sole is dangerous)
• Gout;
• Arthritis;
• Infectious diseases.

Since it is impossible to completely exclude the causes (especially increased activity), it is worth at least reducing the intensity. Constant physical activity of the ankle joint will have a positive effect, which will help strengthen the muscles and further reduce the likelihood of an inflammatory process.

Causes

Achilles bursitis develops for a number of reasons:

• Incorrect foot position while moving.
• Excessive stress on the legs. Inflammation begins when the foot is constantly overstrained, for example, when climbing a mountain for a long time, when running, or when wearing uncomfortable shoes.
• Consequences of the injury.
• Excess body weight.
• Infection of the synovial bursa.
• Chronic inflammatory processes in the joints (with ankylosing spondylitis or rheumatoid arthritis).
• Disruption of metabolic processes and associated poor vascular conductivity in gout and diabetes.

Causes of foot bursitis

Achilles bursitis treatment

Treatment is carried out only after diagnosing the puncture and determining the causes of the disease. The main principles are the elimination of the factor that caused the inflammation, antibiotic therapy, immobilization of the joint and symptomatic treatment (that is, pain relief, physiotherapy if necessary). Having Achilles bursitis, treatment should be selected exclusively by a doctor, since it must be individual, taking into account all the characteristics of the body. Surgical treatment is rarely performed.

Treatment using kinesio taping

If you have Achilles bursitis, treatment with kinesiotaping is considered only an additional method, which alone cannot replace antibiotics and physiotherapy. However, fixation of the joint with elastic bandages is necessary so that the inflammatory process does not affect other structures and the pain does not cause serious inconvenience.

Alternative treatment and its possible consequences

Traditional methods of treatment include:

• Warm compresses - their danger is that they dilate the capillaries and can contribute to the spread of the inflammatory process;
• Applying ice to reduce pain - hypothermia is possible;
• Taking sedatives and painkillers of plant origin may result in insufficient effect and an allergic reaction.
• Treatment with folk remedies is possible only after consulting a specialist.

You may be interested in the treatment of muscle pain, heel spurs, epicondylitis, treatment of joints, cervicalgia, lower back pain, Osgood-Schlatter disease, lateral epicondylitis, treatment of scoliosis, elbow bursitis, hallux valgus, tendonitis, flat feet, metatarsalgia, plantar fasciitis.

ACHILLOBURSITIS

Achilles bursitis is an inflammation of the synovial fluid in the joint capsule - the bursa, at the site of attachment of the Achilles tendon to the heel bone. There are two such bags: one behind the heel, and the other between the tendon and the bone.

These two bags perform mainly a shock-absorbing function. Inside the bags there is synovial fluid, which, for a number of reasons, can become inflamed and manifest as an effusion (bump) on the heel.

As you can see in the figure, one bursa is in close proximity to the Achilles tendon and its inflammation can cause Achilles tear.

This disease is called Achilles bursitis. An Achilles tear in itself is called Achillodynia. Very often, achillobursitis and achillodynia occur simultaneously, but these are two different diseases.

ACHILLOBURSITIS THERAPY OUR ADVANTAGES

Our clinic has all the physical factors for proper and comprehensive treatment of achillobursitis: shock wave therapy, laser therapy, ultrasound, hivamat apparatus, etc.

MAGNETOTHERAPY

SHOCK WAVE THERAPY

When treating Achilles bursitis using the UVT method, magnetic therapy is free!!!

Achilles bursitis - causes

Inflammation of the bursa can occur for many reasons, the most common reasons are listed below. Inflammation is usually clearly visualized as a lump near the Achilles tendon, swelling of the tendon itself, and is often accompanied by ossification. Naturally, this kind of disorder causes pain when walking or manifests itself in the form of starting pain after a long period of rest or when trying to rise on your toes.

The main causes of achillobursitis include the following:

• Heel or ankle injuries
• Excessive stress on the calf muscles (especially in athletes)
• Wearing the wrong shoes (high heels, narrow shoes)
• Some diseases (arthritis, rheumatoid arthritis, gout, heel exostosis and some others)

Achilles bursitis - treatment

Achilles bursitis, like any other inflammation, has varying degrees; in some cases, the disease may even be accompanied by a purulent inflammatory process or the formation of a dense lump at the back of the heel. The ligament seems to swell, which can also be considered as the cause of Achilles bursitis.

Currently, shock wave therapy (SWT) is considered the most effective and non-invasive method of treating both achillobursitis and achillodynia. But it should be used only taking into account the stage of the inflammatory process. Naturally, in the presence of purulent inflammation, other treatment methods should be used (laser therapy, magnetic therapy, ultrasound therapy), namely those methods that will help reduce inflammation, remove excess fluid and activate tissue regeneration processes.

It is well known that UVT not only stimulates metabolic processes, but also significantly accelerates tissue regeneration.

When carrying out proper treatment of Achilles bursitis, it is necessary not only to eliminate inflammation or pain, but also to activate regenerative processes at the site of the pathological focus. The area of ​​influence of UVT is indicated in the photo.

Acoustic waves generated by the UVT device easily propagate through soft tissues and are focused directly at the Achilles-bone boundary, where an inflammatory process or tear of the ligament usually occurs as a result of its ossification.

It is not uncommon that at the site of inflammation (and this is most often the site of attachment of the Achilles to the heel bone), a process of ossification is observed - when the elastic tissue of the ligament changes its structure and becomes more rigid and susceptible to chronic tears.

At the end of treatment, the ligament is restored, inflammation and swelling are significantly reduced. But if during the examination there is a significant effusion due to excess exudate, then additional therapy to reduce it is necessary before performing UVT procedures.

Read more about the therapeutic mechanisms of shock wave therapy in our article “SWT treatment”

How to treat bursitis with folk remedies

As an additional therapy, treatment with folk remedies at home should be used. They will help relieve pain and inflammation and have a positive effect on the overall course of treatment.

Black radish compress

This remedy perfectly relieves pain, swelling, and helps activate metabolism. To do this, grate the radish, put it on gauze and apply it to the sore leg for an hour. But to avoid skin burns, first lubricate the leg with vegetable oil. The procedure is done twice a day, morning and evening for two or three weeks.

Honey compress

Mix aloe (1 part), honey (2 parts) and vodka (3 parts). The resulting mixture is applied to the affected limb, wrapped and left overnight.

Honey compress for bursitis

With horseradish

Horseradish is grated and placed on cheesecloth. The skin is pre-lubricated with glycerin and a compress is applied. This remedy should be used for up to two weeks, as it relieves inflammation well and has an antiseptic effect.

Alcohol tincture of lilac

Lilac leaves have an analgesic effect and help with purulent diseases. You can apply fresh leaves to sore joints or pour alcohol into them, and then make compresses. Lilac flowers are also used for compresses at home.

Prevention

In order to avoid exacerbation of achillobursitis, the following preventive measures must be observed:

1. Reduce stress on joints.
2. Wear orthopedic shoes that do not compress the foot.
3. You should regularly take care of your feet, do massages, and do physical exercises that are aimed at maintaining the tone of the leg muscles.
4. Control your weight.
5. Before playing sports, you should warm up your muscles.

Achilles bursitis is a rather unpleasant disease that does not allow a person to move normally. Fortunately, it is very treatable. It is important not to let such a disease progress, and then an easy, pain-free gait will be a reward for taking care of your body.

Therapy

The doctor decides how to treat achillobursitis. In the chronic form of the disease, the disease that provoked the disease is first treated. But eliminating the cause is not enough; the tendon itself must be treated. It starts with anti-inflammatory drugs and physiotherapy.

If ligament rupture does not occur, then surgery is almost never prescribed. The exception is when the patient is very young. The fact is that conservative treatment helps treat Achilles tendon bursitis, but at the same time the leg muscles weaken, and the risk of re-injury increases sharply. Treatment is carried out in a complex (medicines, physiotherapy, folk remedies).

Conservative therapy:

• The affected limb must be protected as much as possible from overexertion (whether it is bursitis of the big toe, little toe, ankle). To do this, you should choose orthopedic shoes.
• In the acute stage, it is necessary to provide complete rest to the leg and apply a pressure bandage to the heel area.
• For severe pain, apply cold compresses to the affected area.
• The doctor prescribes anti-inflammatory drugs such as Diclofenac, Ibuprofen. Steroids may be prescribed. For acute bursitis, anti-inflammatory non-steroidal drugs, hormone injections into the joint, and antibiotic therapy are prescribed. To reduce pain, injections of anesthetics and glucocorticosteroids are prescribed into the Achilles tendon area.
• A special ankle brace is put on the leg or wrapped with an elastic bandage.
• If Achilles bursitis has developed due to excess body weight, then diet and exercise are recommended.
• Ankle bursitis is treated with external remedies. These are anti-inflammatory ointments Deep Relief, Indomethacin, Nise, Ibuprofen, Finalgon, Ketonal, Betamethasone, Naproxen.
• If bursitis of the foot occurs as a result of injury or physical strain, physiotherapeutic treatment is prescribed: electrophoresis, shock wave method, dry heat heating, phonophoresis, paraffin therapy, ultraviolet irradiation.

Remedies for the treatment of ankle bursitis

Surgical treatment

If achillobursitis becomes chronic or the disease is purulent in nature, then surgical intervention is required. A puncture is made and the synovial bursa is washed with antiseptics and antibiotics. Damaged tissue is removed.

If the process has already become severe, then the heel bone is removed. The doctor removes tissue from around the tendon and examines it. If there are degenerative changes or thickening, then plastic surgery may be prescribed. If the tendon ruptures, the hematoma and damaged tissue are removed. Then the tendon sheath is restored.