Ankle bursitis: photos of symptoms, medication and alternative treatment

What is ankle bursitis?

Inflammation of the ankle joint occurs due to overuse

The ankle joint is exposed to stress every day during movement. Any injuries and bruises of this joint are potentially dangerous for the development of bursitis of the ankle joint - inflammation in the bursa or synovial bursa.

There are 4 of them in the ankle - two of them are in the area of ​​the heel bone, one is located at the junction of the Achilles tendon with the heel bone, and one is located directly on the sole. The exact name of ankle bursitis depends on the location of the inflammatory process. In the vast majority of cases, people experience inflammation of the Achilles tendon or heel bursa, since these areas are most susceptible to injury during movement.

With ankle bursitis, the symptoms are quite specific, which allows for self-diagnosis. Having noticed the symptoms of the disease, you should immediately begin treatment and not delay it, as the disease greatly impairs the quality of life and can lead to complications.

Prevention

The following measures to prevent the disease will help prevent the development of ankle bursitis:

• protection of the foot and ankle with braces and compression socks;
• warm-up exercises before exercise (before sports training, dance rehearsals, hard work);
• comfortable everyday shoes with low speed and sports shoes with a special shock-absorbing sole;
• getting rid of excess weight;
• treatment and prevention of diseases that can cause bursitis (chronic infections);
• daily relaxing ankle and foot massage;
• a set of physical therapy exercises (to strengthen and stretch the muscles of the joint).

Reasons for development

The ankle is subject to constant stress and is often injured

The main reason for the development of bursitis of the ankle and foot is excessive stress on the joints. This happens in the following cases:

• being overweight;
• intense sports activities;
• standing work.

All these factors disrupt the normal distribution of load on the ankle and foot and can lead to the development of bursitis. Also, pathology often develops against the background of injuries and bruises. In this case, the cause of the disease is a violation of metabolic processes in the joint capsule, which leads to the accumulation of synovial fluid and the development of the inflammatory process.

Bursitis can be a complication of other joint pathologies. It accompanies arthritis and arthrosis. Post-traumatic bursitis of the Achilles tendon or heel bursa is observed in professional athletes involved in jumping.

• Most often, ankle bursitis is associated with wearing ill-fitting shoes. Narrow high-heeled pumps, flat-soled ballet shoes, shoes made of low-quality fabrics or small sizes - all this compresses the bursa and leads to an inflammatory process.

Separately, infectious bursitis is distinguished. They develop due to infection of the synovial bursa. This happens in two ways - when an infection enters the bursa through the bloodstream, or when the tissue around the bursa is damaged and becomes infected.

Infectious bursitis can be specific or nonspecific. Nonspecific inflammation is caused by opportunistic microorganisms. These can be staphylococci, streptococci, less often - Escherichia coli and Pseudomonas aeruginosa, yeast fungi. Infection occurs due to the presence of a chronic focus of infection.

Purulent bursitis or abscess of the bursa is most often caused by Staphylococcus aureus.

Infection often occurs against the background of damage to the integrity of the skin around the bursa, or due to chronic infectious diseases. Purulent bursitis can be caused by boils on the skin of the feet and legs.

Specific inflammatory processes in the bursa develop with gonorrhea, syphilis or tuberculosis. Inflammation is associated with the penetration of pathogens of these diseases into the joint capsule; infection occurs through the hematogenous route. Such forms of the disease are very dangerous, since without treatment, pathogenic agents will continue to move throughout the body, affecting more and more bursae, joints and even bones.

Causes and predisposing factors

There are many reasons for the development of ankle bursitis. For example, these may be chronic diseases, against the background of which the shell of the joint capsule loses its strength and is more easily damaged under the most ordinary circumstances (for example, when changing shoes).

But more often, pathology occurs as a result of injury (impact, bruise) or penetration of infectious pathogens (through a wound or through blood vessels, from distant foci).

The main reasons for the development of pathology:

1. Traumatic tissue damage (impacts, bruises, cuts).
2. Defects in the structure of the foot (flat feet, weakness of the ligaments).
3. Infections (syphilis, streptococcal and staphylococcal infections).
4. Joint diseases (psoriatic, gouty, rheumatoid arthritis, arthrosis).
5. Purulent inflammation of adjacent tissues (osteomyelitis, abscess).
6. Metabolic disorders (diabetes mellitus, gout).
7. Systemic connective tissue diseases (scleroderma).

Sometimes the cause of bursitis cannot be determined, and it is considered idiopathic (arising for unclear reasons).

Predisposing factors play an important role (they weaken the bursa tissue and increase the likelihood of damage):

• poor posture and structural defects of the musculoskeletal system (spinal deformity, shortening of one leg);
• natural aging of tissues (after 60 years);
• excess weight;
• allergy;
• weakened immunity;
• poisoning with toxins and drugs (chronic alcohol intoxication, long-term use of corticosteroids);
• physical and household stress;
• uncomfortable shoes;
• profession (dancers, athletes);
• hypothermia (hypothermia).

Flat feet (pictured) may be one of the reasons for the development of bursitis

Symptoms of ankle bursitis

Tendon swelling, redness and pain are signs of bursitis

The main symptom of any bursitis is pain. When the ankle joint is affected, the specific manifestations of the disease will depend on the exact localization of the inflammatory process.

When the Achilles tendon becomes inflamed, the following occurs:

• severe swelling of the tendon;
• pain when walking;
• redness of the skin in the area of ​​inflammation;
• local increase in epidermal temperature.

As a rule, pain with achillobursitis intensifies while walking. This occurs due to compression of the swollen bag by the heel of the shoe. During movement, the foot rises slightly, and the inflamed area rubs against the shoe, which increases inflammation and aggravates the pain.

Symptomatic manifestations of articular bursitis of the ankle joint under the heel are severe pain. The swelling is not visible outwardly, since the bursa is hidden behind the bone. The pain intensifies with any load on the foot. The same symptoms are characteristic of inflammation of the bursa on the sole.

Treatment for ankle bursitis depends on the type of inflammation and symptoms. With purulent bursitis, severe swelling and pain when pressed are observed. The skin temperature in the inflamed area increases significantly, the pain syndrome is acute, pulsating, and does not go away at rest. With an abscess and purulent inflammation, body temperature also rises, there are symptoms of intoxication, severe headache and fatigue. This form of the disease is very dangerous and requires timely treatment.

What is bursitis

There are several types of bursitis depending on location:

• Achilles bursitis of the ankle joint - pathology of the calcaneal tissues and Achilles tendon;
• calcaneal bursitis - affects the heel and subcutaneous-calcaneal receptacle;
• bursitis of the joint of the big toe - is expressed in the curvature and protrusion of the toes.

When the joint capsule becomes inflamed, its functions are disrupted, and pathological effusion, that is, blood or pus, accumulates in the cavity.

The disease occurs in acute or chronic form. A similar pathology can also occur in the hand, where the structure is similar to the foot - bursitis of the wrist joint.

Why is bursitis dangerous?

Thickening of the bursa can lead to disruption of local metabolic processes

Bursitis can become chronic. This is accompanied by a temporary subsidence of symptoms, however, with any stress or compression of the bursa, the pain will return. Chronic inflammation is dangerous due to the thickening of the bursa, which leads to disruption of local metabolic processes. Against this background, the functionality of the joint deteriorates, degenerative-dystrophic changes in the cartilage and inflammation in the joints may develop. When the walls of the bursa are thickened, surgical excision of the altered tissues or complete removal of the bursa is practiced.

Infectious arthritis is especially dangerous because pathogenic microbes can spread to the joints and surrounding tissues. With purulent inflammation or an abscess, there is a risk of infection of the entire body due to the entry of purulent masses into the general bloodstream, which leads to sepsis.

Diagnosis of bursitis

There are several methods for diagnosing bursitis.

A characteristic sign of ankle bursitis, the symptoms and treatment of which depend precisely on the location of the inflammation, is swelling, noticeable in the photo, and pain is always present. The appearance of these two signs should force the patient to urgently consult a doctor.

To make a diagnosis:

• visual inspection;
• palpation of the diseased area;
• radiography of the joint;
• MRI;
• puncture.

An experienced doctor can make a preliminary diagnosis only based on examination and palpation. X-rays are necessary to exclude other articular pathologies, such as arthritis and arthrosis; MRI is done in order to obtain a complete picture of the condition of the soft tissues and bursa.

A puncture is performed to collect a sample of synovial fluid from the inflamed bursa.

The liquid is then examined under a microscope for pathogenic microorganisms. This method allows you to accurately determine the nature of inflammation.

Diagnostics

Bursitis can be confused with other diseases that have similar symptoms. Therefore, before starting treatment, an orthopedic surgeon or trauma surgeon conducts a thorough diagnosis.

At the first visit, the patient is interviewed to determine the symptoms, the nature of the pain, possible causes, and localization. After this, the doctor examines the affected limb, identifies the presence of swelling and redness, and palpates the joint.

In addition to the examination, the following studies may be prescribed:

1. X-ray. X-rays are performed to rule out a bone fracture or crack.
2. Ultrasound. Ultrasound examination is an additional diagnostic method. It is performed to assess the internal condition of the joint capsule.
3. Puncture. The procedure is both diagnostic and therapeutic. Synovial fluid is collected for laboratory testing, as well as to remove excess exudate from the joint.

Based on clinical, instrumental and laboratory criteria, a diagnosis of bursitis is made and treatment is prescribed.

Drug treatment

The medicine is prescribed after bacterial culture of the synovial fluid.

Drug treatment of ankle bursitis is carried out using the following drugs, which should be prescribed by the attending physician:

• non-steroidal anti-inflammatory drugs;
• decongestants;
• glucocorticosteroids;
• antibiotics.

Treatment begins with the prescription of non-steroidal anti-inflammatory drugs - Diclofenac, Ibuprofen or analogues. These remedies quickly relieve symptoms, reduce pain and inflammation. They are used in various dosage forms - tablets, injections, ointments. However, such drugs do not cure bursitis, but only relieve its symptoms.

For severe swelling, glucocorticosteroid therapy is used. These medications are administered by injection directly into the joint capsule; tablets are less commonly prescribed. Drugs in this group quickly and effectively relieve inflammation and eliminate swelling.

Antibiotics are prescribed only when the infectious nature of the inflammation is confirmed.

The choice of drug depends on the causative agent of the disease. The medicine is prescribed only after bacterial culture of the synovial fluid and determination of sensitivity to antibiotics.

Surgical methods of treatment

Antibacterial therapy prevents recurrence of infection

With an abscess in the ankle, therapy and treatment of ankle bursitis are aimed at cleansing the bursa from purulent masses. To do this, an incision is made and the bursa is thoroughly cleaned using special instruments. Antibacterial therapy is then carried out to prevent recurrence of the infection.

When the walls of the bursa are thickened due to chronic inflammation, surgical excision of tissue is practiced.

Folk remedies

In addition to drug treatment, you can use traditional medicine recipes

For ankle bursitis, treatment with folk remedies can be used in addition to drug therapy. It is recommended to use such methods only after the approval of a doctor.

Traditional methods and folk methods for treating ankle bursitis:

• cold compresses with ice and improvised means;
• white cabbage leaves;
• propolis tincture for rubbing;
• propolis ointment.

Cold compresses help relieve swelling.

You can apply ice, frozen foods, or chilled glass to the affected area. The main condition is indirect exposure, that is, the cold object is first wrapped in a towel. Keep the compress for 15 minutes. You can do this 3-4 times a day.

White cabbage leaves are first kneaded with your fingers and applied to the sore joint overnight. To prepare propolis ointment, you need to slowly dissolve 10 g of the product in butter simmering in a water bath. The ointment should be applied twice a day.

How to treat bursitis

The treatment tactics are selected by the attending physician depending on the characteristics of the disease, the causes of its occurrence, and the stage of development.

In case of acute manifestations of the disease, it is necessary to provide rest to the affected joint. For this, various devices are used: elastic bandages, plaster casts, splints (photo). To make walking easier, it is recommended to use crutches or a cane.

As with any other inflammatory diseases of the joints, complex treatment is prescribed:

• drug therapy;
• physiotherapy;
• physiotherapy;
• treatment with folk remedies.

An important factor in accelerating recovery is following a special diet. Experts suggest including foods rich in vitamins A, B. C in your diet, and eating dishes containing gelatin at least three times a week.

If the disease does not respond to conservative treatment, or purulent exudate has accumulated in the joint, it becomes necessary to resort to surgical intervention.

Various devices are used to immobilize the joint.

Drug therapy

Drug therapy is designed to eliminate the causes of the disease, symptomatic manifestations, and restore the function of the ankle joint. To do this, use painkillers and anti-inflammatory drugs, antibiotics (in the case of infectious bursitis), vitamins, chondroprotectors, and perform hormone injections into the joint cavity.

Modern pharmacies offer a wide selection of medicines for the treatment of pathologies. You need to prepare for the fact that the price of the drugs will be quite high, but without them it is impossible to achieve a positive result.

Despite the fact that each package contains detailed instructions for using the medicine, self-medication is dangerous. Medicines are taken only as prescribed by the attending physician.

Table No. 2. Medicines used to treat bursitis:

Physiotherapeutic treatments

After the acute manifestations of the disease have been relieved, the patient will be offered to undergo a course of physical treatment. The procedures will help eliminate the inflammatory process, pain, restore the functions of the affected joint, blood circulation and nutrition.

Table No. 3. Physiotherapy procedures and their effects:

A universal physiotherapeutic method for treating bursitis is shock wave therapy. This method has all of the above effects on the joint, and thanks to it, lasting positive results are achieved.

Physiotherapy

Physical therapy is an integral method in the complex treatment of bursitis. It is prescribed to restore range of motion in the affected joint.

The exercises are developed by the instructor and carried out under his supervision. And only after the patient has mastered the set of exercises well, he will be able to practice independently.

Exercises that are recommended to be performed for ankle bursitis can be viewed in the video in this article.