The bursitis of the Achilles tendon
definition
In medicine, subachillae bursitis is the inflammation of a bursa beneath the Achilles tendon (subachillae). The fluid-filled bursa are used to reduce rubbing and pressure forces on tendons, bones and joints. As a result of constant improper stress, inflammation can occur, which can be either acute or chronic.
The reasons
The causes are varied. In addition to prolonged incorrect or excessive stress, wearing the wrong footwear (shoes that are too tight in the area of the Achilles tendon and the heel), incorrect positions in the area of the foot and ankle (e.g. archesus, arches, etc.) as well as too quickly increased training volumes for athletes subachillae bursitis.
The occurrence of a so-called heel spur is also counted among the causes. This is a spur-like, mostly pointed bone protrusion in the area of the heel or the calcaneus. The consequences are constant irritation and increased pressure in this area. In rare cases, bacterial inflammation can also lead to the disease.
For more information, read on: Heel spur.
The accompanying symptoms
The central leading symptom of the disease is pain occurring at rest and under stress. At the same time, swelling, reddening and warming as well as thickening of the affected tendon occur due to increased fluid formation. In addition, movement restrictions in the ankle and foot may be possible.
Find out all about the topic here: Bursitis.
The diagnosis
The diagnosis is made, in addition to a detailed physical examination by the treating doctor, by means of an ultrasound examination. This allows the extent of the inflammation and any existing damage to the Achilles tendon to be shown very well.
In order to be able to precisely assess the position and shape of an existing heel spur, an X-ray image of the foot is taken in two different viewing planes. In some cases, an MRI (magnetic resonance tomography) is also necessary for an accurate diagnosis.
The treatment
Treatment depends on the extent and severity of the disease. It can be done either conservatively or surgically. Nevertheless, conservative therapies should first be used before surgical removal of the bursa (bursectomy) is considered.
Basically, the load on the foot and the Achilles tendon must be reduced and a break in sports must be taken. Pain relief is provided by taking pain relievers, anti-inflammatory drugs such as Diclofenac. Physiotherapeutic exercises, heat or cold applications can be used at the same time.
If the cause is a misalignment of the foot, special, individually manufactured insoles by a trained orthopedic technician are the method of choice. The injection of cortisone, usually together with an anesthetic, into the inflammatory tissue is also used nowadays. However, this should not be done more than 2 to 3 times, as a longer duration of therapy leads to damage to the tendons and the surrounding tissues.
Ointment dressings are also a means of conservative therapy. In addition to their mostly cooling effect, they have an inhibiting effect on inflammation and pain. Many patients have had good experiences with the so-called "horse ointment". This ointment actually comes from veterinary medicine, but due to its healing and cooling function, it can also be used for problems of the human body.
The application of splints or even a cast to immobilize the affected area should only be done in very serious cases. This method leads to a significant reduction in muscle and tendon strength as well as to a decrease in the interplay between the various muscle groups.
Also read the article: Home remedies for bursitis.
When do I need an operation?
If the conservative therapies do not bring the desired success, there is the possibility of surgical removal of the bursa. In an open surgical procedure, the bursa is removed through an incision over the inflamed tissue.
Some clinics also offer this procedure in a minimally invasive manner with the help of an endoscope. An endoscope is a narrow tube through which you can insert a small camera and cutting instruments. This allows the Achilles tendon and the bursa to be assessed and operated on. The advantages are a smaller surgical wound, a lower risk of infection, less pain after the operation and a shorter recovery time.
Find out more about the topic here: Surgery of a bursitis.
The duration
The time it takes to fully recover depends on how severe the inflammation has progressed and whether other structures are affected as a result. At the same time, the recovery time varies depending on the type of therapy chosen (conservative or surgical). Under normal circumstances, symptoms will improve significantly after a few weeks if the reasons for the disease are identified and treated appropriately. If this is not the case, the inflammation can also be chronic, which can then only be remedied by surgical intervention.
In principle, the disease can be treated relatively easily and completely if it is detected early enough. As a preventive measure, you should ensure that tendons and muscles are strengthened and you should avoid constant pressure on the structures mentioned.
For more information, also read: The duration of a vaginal inflammation.
