The body has a number of mechanisms that help cushion and lubricate joints and bones. One of these is called the bursa, a fluid-filled sac that separates, cushions and lubricates in order to reduce the friction between two surfaces that move in opposing directions. In the process of protecting these structures from becoming inflamed, the bursa itself can become inflamed—
a condition called “bursitis.”
In the foot, there is only one naturally-occurring bursa. It is located between the Achilles tendon and the heel bone (calcaneus). This bursa protects the Achilles tendon from the pressure of the heel bone pressing against it during walking and running. This is the most common area of bursitis in the feet, also known as retrocalcaneal bursitis.
In addition, bursitis can occur in the toe joints, the side of the foot, and the heel and around the ankle. Since the feet take such a tremendous load as we go about our daily tasks, there are several points in the foot that can develop bursitis due to added pressure and rubbing.
Causes of Bursitis
The feet are subjected to ongoing stress when walking and doing other activities on unfriendly surfaces such as concrete, asphalt, and hard floors. This foot stress is often exacerbated by poorly designed and fitted shoes. The effects of pressure, impact and shear force can damage the feet over time. The body’s response to this damage is to create a bursa that protects weight-bearing and joint areas. Many times, the bursa itself becomes inflamed.
Symptoms of bursitis usually are specific to the affected area, and may include:
- Pain, especially with walking, running, or when touched.
- Increased pain intensity when standing on tiptoes.
- Red, warm skin over the affected area.
- Use cushioned insoles and padding to help relieve places in your shoes where you feel pressure.
- Use deep cushioning heel cups to help provide additional shock absorption. Wear comfortable shoes that fit your feet.
- If your bursitis pain is located in the ball of your foot or toes, wear shoes with a large toe box
- Stop any strenuous activities that put pressure on your feet
- Apply ice or cold packs to your foot every 15 minutes to help reduce swelling and inflammation.
- Take over-the-counter pain relievers such as ibuprofen or naproxen as needed.
A common condition that can cause bursitis in the heel area is Haglund’s deformity, a bony enlargement on the back of the heel. In this condition, the soft tissue near the Achilles tendon becomes irritated when the bony enlargement rubs against shoes, especially the rigid heel counters of high heel pumps. Haglund’s deformity is often called “pump bump,” and it generally affects women.
If your bursitis persists or gets worse, we recommend that you make an appointment with your doctor. You may need anti-inflammatory medicines such as cortisone or steroids to help shrink the bursa, such as a corticosteroid injection to relieve severe irritation. In especially bad cases, your bursa may need to be surgically removed.