Achilles bursitis
The content of the article:
- Causes and risk factors
- Forms of the disease
- Symptoms
- Diagnostics
- Treatment
- Possible complications and consequences
- Forecast
- Prevention
Achilles bursitis is an inflammation of the bursa located between the Achilles tendon and the heel bone.
Achilles bursitis refers to diseases of the musculoskeletal system and requires timely treatment, since it significantly impairs the patient's quality of life and can have serious complications.
Inflammation of the bursa with achillobursitis
Causes and risk factors
The main causes of the disease are excessive stress and injury (as a result) of the Achilles tendon, which connects the muscles of the back of the lower leg with the heel bone and nearby soft tissues:
- systematic long-term overload with monotonous movements (walking long distances, professional sports);
- unusual intense load, for example, playing sports (running, jumping, cycling, strength exercises with targeted involvement of the muscles of the lower extremities) without preliminary preparation;
- uncomfortable, tight shoes, shoes with excessively high heels (the risk increases with the alternation of wearing shoes with high heels and flat soles);
- single mechanical damage, systematic microtrauma;
- overweight;
- flat feet with hyperpronation.
In addition to the traumatic effect, the cause of Achilles bursitis can be:
- autoimmune and allergic processes;
- systemic inflammatory diseases;
- metabolic disorders (the presence of uric acid salts in the synovial fluid with gout, calcium pyrophosphate crystals with chondrocalcinosis);
- hematogenous and lymphogenous infection with tuberculosis, osteomyelitis, sepsis, AIDS and other generalized infections, gonorrhea (gonorrheal bursitis), etc.;
- age-related involution;
- congenital anomalies in the development of the musculoskeletal system;
- prolonged hypodynamia (immobilization) with impaired blood supply to the tendon zone;
- inflammatory changes in the ankle joint with damage to the periarticular soft tissues.
Forms of the disease
Depending on the specifics of the course, achilloburitis can be:
- sharp;
- subacute;
- chronic.
By the nature of the pathogen:
- non-specific;
- specific (gonorrheal, syphilitic, brucellosis, etc.).
Achilles bursitis can be acute, subacute, chronic
By the nature of the content:
- serous;
- purulent;
- hemorrhagic;
- fibrinous.
Symptoms
Main manifestations:
- aching pains in the tendon area, sometimes along the back of the lower leg after running or physical exertion, which are significantly worse when walking or standing for a long time;
- swelling or swelling above where the tendon attaches to the heel bone
- the presence of painful limited protrusion of elastic consistency on the back of the heel;
- increased pain when bending the foot, when pressing on the Achilles tendon in the place of its attachment;
- thickening and swelling of the tendon.
In an acute process, an increase in body temperature up to 38–39 ° C is possible, a deterioration in general well-being, in the heel area - edema and hyperemia of soft tissues, pulsation and sharp soreness.
Achilles bursitis is characterized by pain in the tendon area after running or exercising
In the chronic course of the disease, the symptoms are less pronounced; redness, soft tissue swelling and fever are absent.
Diagnostics
If bursitis is suspected, the following diagnostic measures are prescribed:
- a general blood test (an increase in the number of leukocytes, an increase in the erythrocyte sedimentation rate are detected);
- biochemical blood test (for markers of inflammation);
- puncture of the synovial cavity with subsequent examination of the punctate;
- X-ray examination of the ankle joint;
- Ultrasound of the ankle (foot).
Treatment
Therapeutic treatment of achillobursitis is carried out in a complex way:
- pharmacotherapy - glucocorticosteroid, antibacterial drugs injected into the cavity of the bag, non-steroidal anti-inflammatory drugs inside (injectable) and topically;
- shock wave therapy;
- physiotherapy procedures;
- with flat feet - correction using medical insoles, shoes, orthoses;
- limiting the load on the limb (tight bandaging, orthopedic shoes, ankle brace).
The introduction of glucocorticosteroids is made only into the synovial cavity; the introduction of drugs directly into the thickness of the tendon is strictly prohibited, as it can provoke its rupture.
Ankle support limits the load on the limb
If conservative therapy is ineffective, surgical treatment is performed - excision of the overstretched area of the synovial bag. With the development of purulent bursitis, opening, debridement and drainage of the inflamed cavity are shown.
Possible complications and consequences
The main complication of acute Achilles bursitis is the transition of the process to a chronic form, which reduces the quality of life and leads to disability (in severe cases).
When an infection is attached, the following complications may develop:
- phlegmon;
- sepsis;
- purulent bursitis.
Forecast
With timely complex treatment, the prognosis is favorable.
Prevention
In order to prevent achillobursitis, you need:
- competent dosing of physical activity;
- compulsory warm-up before doing exercises that involve the muscles of the lower extremities;
- wearing comfortable shoes with a moderate heel height;
- weight loss;
- timely treatment of injuries and acute diseases.
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Olesya Smolnyakova Therapy, clinical pharmacology and pharmacotherapy About the author
Education: higher, 2004 (GOU VPO "Kursk State Medical University"), specialty "General Medicine", qualification "Doctor". 2008-2012 - Postgraduate student of the Department of Clinical Pharmacology, KSMU, Candidate of Medical Sciences (2013, specialty "Pharmacology, Clinical Pharmacology"). 2014-2015 - professional retraining, specialty "Management in education", FSBEI HPE "KSU".
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
