Bursitis

Bursae are fluid filled sacs which help protect particular structures of the body from friction. In the foot there is only one naturally occurring bursa which lies between the Achilles tendon at the back of the heel and the heel bone (calcaneus). It helps the tendon slide easily over the bone.

Feet are constantly undergoing repeated stresses during walking and other normal activities. These stresses are compounded by ill fitting shoes. With every step, the pressures and shearing stresses upon the feet cause damage and the body responds by forming bursae. As a consequence there are many bursae on the feet. Again, their purpose is to protect the structures from further damage.

Common sites for these include over the big toe joint, commonly mistaken for a 'bunion' and over the tops of the toes.

From time to time. these bursae become inflamed due to even more pressure or trauma and produce the painful condition known as bursitis.

Bursitis may occur as a result of exposure to cold weather or injury during contact sports. The bursae may also be irritated as a result of any direct trauma, inadequate 'warming up' prior to exercise or excessive repeated exercise as in long distance running. They may be due to friction from a shoe.

 The naturally occurring bursa behind the heel often becomes inflamed in this way, due to the heel counter of a shoe rubbing against it. This is called Haglunds Deformity and is most common amongst females.

Pain occurs as a protective mechanism to warn you to stop doing whatever it is that is causing the pain, to prevent further destruction.  This is not always very easy, or practical. Try the obvious things first and attempt to reduce the inflammation with ice therapy and find some footwear that is comfortable.  Often, immobilising the affected area with some strapping (tape) may reduce the friction. Padded socks or soft gel toe protectors often relieve the symptoms.

If the pain refuses to subside, there may be an infection, arthritis or gout and a visit to your GP or a podiatrist will help to identify the problem.

 A biomechanical assessment may provide evidence of walking difficulties as a causative factor of bursitis, and corrective insoles could prevent the painful condition.