Bursitis

Symptoms are consistent with pain during weight bearing. Certain shoe types can exacerbate the pain as is the case with retrocalcaneal bursitis in patients with Haglund’s deformity. On the other hand, bursitis of the ball of the foot can be relieved by more supportive shoe gear. Ice to the affected area provides relief and so can NSAIDs such as ibuprofen or naproxen.

X-rays are taken in the office to see the overall foot type and to rule out other pathology that may cause similar pain. Patients with high arches tend to overload the ball of their foot with weight bearing which causes bursitis. Similarly, Haglund’s deformity and retrocalcaneal exostosis can be diagnosed on X-ray which also presents with bursitis.

Treatment includes Rest, Ice, compression and elevation along with shoe gear modification. At times a short course of steroids or a potent NSAID is used to calm the inflammation down. Physical therapy and conditioning exercises may also be utilized. Shoe gear modification and custom orthotics are a mainstay of treatment. Surgical intervention is often necessary when conservative treatment fails. This is likely the case with chronic posterior heel pain where bursitis recurs due to the abnormal bony prominence. The bony prominence is surgically resected to relieve pressure on the bursae.