Bursitis is inflammation and swelling of fluid-filled sacs called bursae. These sacs act as cushions near the joints between the bones and tendon/muscle insertion. With 33 joints in the foot, bursae can be found in a multitude of areas. They are commonly found at the ball of the foot (especially the metatarsophalangeal joints), the base of the fifth metatarsal, and the back of the heel near the insertion of the Achilles tendon.
Inflammation of the bursae can be the result of direct pressure or repetitive motion. It can be exacerbated by an underlying foot deformity or medical condition, including Haglund’s deformity, gout, or arthritis.
Pressure-related causes generally include tight shoes or high heels.
Repetitive motion-related causes may include running, jumping, or improper warm-up prior to exercise.
Symptoms of bursitis include pain while walking and running, increased pain when attempting to walk on tip-toe, swelling, redness, or stiffness of a joint, pain with movement of a joint, or pain when touching a joint.
Foot pain is never normal. Everyone with symptoms of foot or ankle foot pain should see a podiatrist. Podiatrists are doctors who are specially trained to treat the feet and ankles.
A comprehensive podiatric examination will help determine and diagnose bursitis. This examination includes questions about what type of exercise a patient performs, what type of sports a patient participates in, and whether the patient’s occupation involves standing and/or repetitive motion.
In addition to a clinical evaluation to look for signs of swelling, redness, or pain, a biomechanical examination and range of motion test, as well as radiographs, would help to determine if there is an underlying food deformity that may be exacerbating the symptoms.
Additional tests may include blood work, MRI, ultrasound, or arthrocentesis (removal of fluid from the bursae), particularly if an infection and/or gout is suspected.
Treatment can include, but is not limited to, discontinuing the activities causing symptoms, stretching muscles and joints before and after workouts, taking anti-inflammatory medication, icing the affected area, wearing shoe inserts or prescription custom orthotics, and wearing properly fitting shoes and socks.
Additionally, steroid injections may be administered. If conservative treatment methods have been exhausted, surgery may be recommended in some cases.
You may be able to prevent bursitis by eliminating pressure or repetitive motion. Wearing properly fitting shoes and padded socks, stretching and completing proper warm-up before activities, and, in some instances, controlling the motion of the foot with the use of orthotics can help.