Achillobursitis: what is it, how to treat?

The appearance of a painful lump or swelling in the heel area, significant discomfort when walking and wearing any shoes except flip-flops, may be a sign of inflammation of the synovial bursa located at the point of attachment of the Achilles tendon to the heel bone (Achillobursitis). Strictly speaking, there are two such bursae on the back of the ankle, the tendon is protected by them on both sides - on the bone side (subtendinous) and on the outside (subcutaneous bursa). They cushion the load on the tendon, the most powerful and strong in our body and, at the same time, the most vulnerable. Any of them or both at once can become inflamed. The appearance of a painful lump on the heel is caused by overproduction and accumulation of synovial fluid in the subcutaneous bursa.

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Epidemiology

Achilles bursitis is less common than inflammation of the synovial bags in other locations. In general, young adult men (under 40) are most susceptible to this disease, which is associated with active sports and work associated with physical activity.

Posterior heel bursitis, as a type of Achilles bursitis, is more common in women who prefer narrow, high-heeled shoes.

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Causes achilles bursitis

Achilles bursitis can occur in acute and chronic forms, and the processes are divided into aseptic and purulent as a result of primary or secondary infection.

Most often, acute inflammation is caused by constant trauma to the calcaneus or overload of the Achilles tendon, when a person repeatedly repeats the same traumatic movement. At risk are people involved in sports where the main load falls on the calf muscles (skating, running, jumping, football, etc.); women who prefer model narrow shoes with high heels; people who wear tight shoes that put pressure on the heel.

The development of Achilles bursitis of infectious genesis is also mainly a consequence of injury to the subcutaneous synovial bursa (puncture, cut) and infection. When immunity is reduced, pathogenic microorganisms from a chronic focus can infect the synovial bursa through the bloodstream or lymph flow.

In the presence of chronic diseases of the joints or connective tissue (arthritis or arthrosis of the ankle, gout, heel spurs, less often - systemic scleroderma), the spread of the inflammatory process or the deposition of salts in the lining of the synovial bursa, chronic Achilles bursitis develops.

Risk factors for the development of Achilles bursitis include preparation for sports competitions, overload during training, insufficient development of muscles and ligaments preceding them, a sedentary lifestyle, additional stress due to excess weight, and old age.

As with any other disease, a serious factor that increases the likelihood of its development is a weakened immune system as a result of acute or chronic recurrent infections, the presence of diathesis in children and allergies in adults, autoimmune diseases, malignant processes and their therapy, alcohol and drug abuse.

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Pathogenesis

Aseptic Achilles bursitis is the result of a closed injury to the synovial bursa due to one of the reasons described. The walls of the bursa (pocket) become inflamed – swell, and undergo cellular infiltration. Serous (accumulation of clear fluid), serous-fibrinous (with an admixture of fibrin protein), fibrinous or hemorrhagic effusion appears in the cavity. The type of internal exudate depends on the severity of the inflammation and the nature of the injury.

The inflamed bursa increases in size, a lump grows on the heel, sometimes quite large (inflammation of the subcutaneous bursa, posterior calcaneal bursitis). When only the subtendinous bursa is inflamed, there is no protrusion, only pain, swelling, sometimes slight, and limited mobility (anterior Achilles bursitis or Albert's disease). The membrane of the enlarged bursa presses on the surrounding tissues and nerve endings, and transudate effusion occurs in the intercellular spaces.

In primary, as a result of penetrating injury, or secondary infection of the internal cavity of the bursa with pyogenic microorganisms, purulent inflammation develops. In most cases, infectious agents are non-specific pathogens - staphylococci and streptococci, much less often specific ones - gonococci, mycobacterium tuberculosis, brucellosis, etc. Secondary infection of the bursa from foci of infection occurs through the lymphogenous route. In pathogenesis, the spread of infection with the bloodstream is also considered.

In the future, without treatment, the purulent process can spread to adjacent tissues as an infiltrative-purulent inflammatory process with necrosis of the bursa membrane and the formation of phlegmon under the skin and between the muscles. Further progression can lead to the formation of long-term non-healing fistulas, and the penetration of pus into the joint pocket provokes the development of purulent arthritis.

Acute Achilles bursitis of traumatic genesis is characterized by the accumulation of hemorrhagic fluid in stretched bursae. Regression in this case is accompanied by the formation of fibrin up to the complete closure of the lumen of the vessels of the bursa wall. Stable structural transformations develop in it - thickening of the walls, connective tissue strands dividing the bursa cavity into smaller sections and subsequently growing into nearby tissues.

During the latent period, encapsulated areas of dead tissue or exudate remain in the bursa membrane and cavity, serving as the basis for another attack of inflammation in the event of repeated injury or infection.

Chronic recurrent Achilles bursitis develops as a result of prolonged and stable mechanical irritation.

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Symptoms achilles bursitis

The first signs of trouble are discomfort when wearing closed-heel shoes, a nagging or sharp pain in the heel or ankle area, which intensifies after a night's rest. When the patient "warms up" it becomes easier.

There is a slight swelling of the ankle, a lump appears on the heel. When loading the heel, the pain becomes stronger, the foot turns with difficulty in the ankle joint, and loading it causes pain.

It is not possible to stand on tiptoes due to severe pain.

If the first symptoms are ignored, the process develops: the pain intensifies, the ankle turns red and swells. As the purulent process develops, the temperature rises, accompanied by symptoms of acute malaise, the pain is pulsating, "twitching" in nature.

The posterior joint bag, located between the skin and part of the tendon that attaches to the heel bone, can become inflamed. Achilles bursitis of the heel bone (posterior Achilles bursitis) begins with a dense formation on the heel, it is very sensitive, located under the skin, as it develops it turns red and hurts more and more. The pain is localized in the heel and above it, when walking.

Another type is Achilles bursitis of the ankle joint (anterior Achilles bursitis, Albert's disease), when the internal anterior bursa becomes inflamed. This type of inflammation most often occurs as a result of injuries (acute) or rheumatoid arthritis of the ankle joint (chronic). Patients complain of pain when wearing shoes with a heel, simply when walking, swelling and increased temperature in this area of the leg. At first, the swelling is observed in front of the tendon, without treatment - it spreads around it.

Psychosomatics

Our mood, behavior and prevalence of certain reactions and character traits make us more or less susceptible to joint diseases, including Achilles bursitis. The psychological background of diseases, their psychosomatics, has been studied for a long time and is considered by different authors. Moreover, completely different authors have made similar conclusions from their observations of patients. Inflammation of the joint capsule, according to Louise Hay, Liz Burbo, Torsunov O.G. develops in people who are often forced to restrain their outbursts of anger, aggression towards others and themselves. These people usually do not give vent to their emotions due to certain behavioral stereotypes that do not allow them to relax, forcing them to restrain emotions, which contributes to the accumulation of grievances and disappointments.

A patient suffering from bursitis is usually a very demanding person, first of all, to himself, striving for perfection even in the most insignificant matters. Accordingly, he accumulates resentment and irritation towards "imperfect" loved ones, colleagues who do not meet such high requirements and, moreover, are not able to appreciate his high standards and achievements. He accumulates anger towards them, which, however, he does not allow himself to express. He also accumulates anger towards himself, he cannot accept and love himself, such as he is. These are people who play the role of a victim in life or, completely opposite, prone to tyranny. In any case, he feels all-consuming self-pity, which develops against the background of suppressed outbursts of rage caused by an unfair (as it seems to him) attitude towards him, the desire to punish the offenders.

Anger accumulates in the joint associated with the situation (if you want to hit with your hand - in the arm joint, with your foot - in the joints of the lower limb). Achilles bursitis reminds the patient that the situation should not be aggravated and delayed. It also does not mean that you need to defuse it by hitting someone. It is necessary to quickly voice your complaints and wishes, discuss the problem and come to an acceptable solution. Complaining about fate and feeling sorry for yourself is not an option. Perhaps it is worth reviewing your priorities. Such people need to learn to communicate effectively with other people, not to make excessive demands on them, and also learn to love themselves and relax, forgiving themselves some weaknesses and perceiving the environment with optimism.

Complications and consequences

Chronic aseptic inflammations are often complicated by the proliferation of cells of the stratum corneum of the epidermis of the bursa and its thickening.

Lack of treatment and continued trauma to the joint capsules leads to complications – the growth of scar tissue continues, which leads to limitations in joint mobility.

Calcification or the development of areas of ossification in the fibrinously modified membrane of the articular capsule leads to ossification or calcareous dystrophy (petrification).

A complication of retrocalcaneal bursitis may be Haglund's deformity (a bone growth on the back of the heel bone) or a ruptured Achilles tendon.

Purulent complications may develop: abscess, fistula, sepsis, necrosis of the tissues of the synovial bursa, purulent arthritis of the ankle joint, persistent impairment of its mobility, osteomyelitis of the shin bones, lymphadenopathy.

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Diagnostics achilles bursitis

After talking and examining the patient, the doctor prescribes tests:

• a clinical blood test will help determine the presence of an inflammatory process and its intensity based on the number of leukocytes and the erythrocyte sedimentation rate;
• If specific infections are suspected, serological tests are prescribed to detect antibodies and antigens to infectious agents;
• Immunological tests are done if there is a suspicion of an allergic origin of the disease;
• rheumatic tests – for the presence of rheumatism;
• bacteriological examination of the contents of the bursa obtained by puncturing.

The most frequently prescribed instrumental diagnostics are ankle X-ray (usually in two projections) and ultrasound examination. Using ultrasound, it is possible to visualize the inflamed bursa, its size and contents (blood, pus, calcifications) on a computer monitor.

If necessary, magnetic resonance imaging or computed tomography may be prescribed, although due to the high cost of the examination, it is rarely used. Usually, the two previous ones are enough to establish a diagnosis.

Differential diagnosis

Differential diagnostics is performed between aseptic and purulent inflammation, the infectious agent is determined. Differentiation is also performed with rupture of the Achilles tendon, Haglund's deformity, heel spur, enthesopathy and xanthoma of the Achilles tendon, fracture of the lateral tubercle of the posterior process of the calcaneus, its erosive changes as a result of rheumatoid arthritis.

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Treatment achilles bursitis

First of all, they try as much as possible to ensure that the heel is not irritated by the back of the shoe (using heel pads, cushions, orthoses and other orthopedic devices). The patient's shoes should have a low heel, be comfortable and spacious (preferably orthopedic), and, if possible, without a heel.

Anti-inflammatory therapy is carried out using local, oral and parenteral anti-inflammatory and analgesic drugs.

Local treatment is carried out using ointment. Sometimes such measures are sufficient.

For example, when treating Achilles bursitis, compresses with a solution of Dimexide or application of this drug to the sore spot in the form of a gel may be prescribed. The active ingredient of this drug is dimethyl sulfoxide. This medicine has the ability to relieve pain at the site of application, also possessing moderate anti-inflammatory and antimicrobial properties. Dimexide is a good conductor and can be used in combination with other solutions or ointments, enhancing their absorption and facilitating transportation to deeper inflamed tissues (up to 5 cm). In combination with novocaine (lidocaine), it enhances the analgesic effect, with hydrocortisone - anti-inflammatory, with antibiotics - enhances their effectiveness, reducing the resistance of bacteria to them (therefore, it is also used for purulent Achilles bursitis).

For aseptic Achilles bursitis, the following compress may help: dilute 15 ml of dimethyl sulfoxide (30-50%) in 75 ml of boiled water and add one ampoule of Hydrocortisone (Prednisolone, Dexamethasone) and 20-30 ml of Lidocaine to the solution. Keep this compress for no more than 60 minutes.

You can use ointments with NSAIDs (Nimesulide gels, Fastum, Dolgit cream, ointments with Diclofenac, Indomethacin). To enhance the effect, they can be combined with Dimexide, first smearing the affected area with ointment, then applying a compress of Dimexide solution in water on top.

Dimexide is toxic, so it can only be used locally in the form of an aqueous solution or gel (ointment). It itself belongs to the NSAID group, so its use in combination with drugs of the same group mutually enhances the overall effect. It is contraindicated for pregnant and lactating women, people with heart disease, liver and kidney disease, glaucoma, children under four years of age. Allergy sufferers should conduct a sensitivity test before using this substance.

Heparin ointment and Troxevasin can help to activate blood circulation, lymph and metabolic reactions in the joint capsule, improving blood microcirculation and microvascular perfusion. Their action is aimed at removing swelling, reducing pain and inflammation, increasing the strength of blood vessels. These products can be used to treat pregnant and lactating women.

Heparin is compatible with Dimexide, however, such compresses should be done as prescribed by a doctor.

Ointments based on snake (Viprosal B) and bee (Apizatron) venom also improve blood circulation in soft tissues and reduce pain and inflammation.

Viprosal B ointment, in addition to snake venom, which is the main active ingredient, contains camphor, turpentine oil and salicylic acid. Which complement the action of the main component with an antimicrobial effect. To eliminate pain and resolve the lump, rub the ointment in up to two times a day. It is not recommended for pregnant and lactating women, patients prone to convulsions and spasms of the respiratory tract.

Apizatron ointment has multifaceted medicinal properties due to the presence of bee venom in it. Other components act synergistically with it - methyl salicylate, which has good penetrating ability, complements the anti-inflammatory effect, allyl isothiocyanate improves blood microcirculation and, therefore, cellular respiration and metabolic processes. The ointment is also not recommended for use by pregnant and lactating women, and people with severe renal / hepatic insufficiency. It is used twice or three times a day, rubbing into the cones.

Both ointments are not applied to damaged skin, do not allow them to come into contact with mucous membranes. After treatment, wash your hands well with soap.

Injections for Achilles bursitis can be prescribed as local procedures. The injection is made directly into the inflamed bursa. This is how painkillers and NSAIDs are administered. This method allows avoiding complications on the gastrointestinal tract from oral administration of nonsteroidal anti-inflammatory drugs (at least reducing the dose taken orally). If there is no effect in the case of aseptic inflammation, a method of aspiration of the bursa contents and introduction of a prolonged-action glucocorticosteroid in its place in combination with an anesthetic is used. In the presence of an infection, it is supplemented with an appropriate antibiotic.

Non-steroidal anti-inflammatory drugs are prescribed in tablets or injections to relieve pain and alleviate inflammation symptoms. In resistant cases, systemic corticosteroid therapy is administered; if specific infections are detected (for example, tuberculosis), patients undergo a course of appropriate therapy.

In the treatment of Achilles bursitis, agents that enhance the patient's immunity are also used. Most often, these are vitamin complexes that contain vitamins C, A, group B, and immunostimulants may also be prescribed. Physiotherapy is widely used. Electrophoresis for Achilles bursitis is used as early as the first week of treatment. With its help, painkillers and anti-inflammatory drugs are administered, while their bioavailability increases and the dose decreases, and with it the likelihood of side effects.

The therapeutic effect of electrophoresis for Achilles bursitis includes normalization of metabolic processes in the ankle joint and increased synthesis of endogenous bioactive substances, vasodilation and activation of blood flow, as well as improved lymph flow, pain relief and inflammation. Typically, a therapeutic course includes ten to fifteen daily procedures.

Shock wave therapy is considered no less effective in Achilles bursitis. The effect is achieved quite quickly with its help. The essence of the procedure is to affect the affected area with infrasound - low-frequency sound waves. They penetrate the bursa well and promote reparative processes in its cavity. Blood circulation in the vessels of the bursa wall improves, the amount of synovial fluid in the cavity of the bursa decreases, the quality and metabolic processes in the membrane are normalized. External changes are visible in the reduction of pain, reduction of swelling, restoration of joint mobility. The procedure is contraindicated for patients with varicose veins, embrittlement and high permeability of blood vessels, as well as with skin pathologies, liver / kidney failure, neoplasms and diabetes.

Laser and ultraviolet therapy, high-frequency electromagnetic fields, ultrasound, paraffin and ozokerite heating, cryotherapy, hirudotherapy, and mud therapy are used to treat Achilles bursitis. In chronic inflammation, X-ray irradiation of the affected joint is practiced.

Acupuncture may be prescribed and has a good effect on aseptic Achilles bursitis.

How to treat Achilles bursitis at home?

Experts say that it is impossible to get rid of Achilles bursitis using home methods; at a minimum, physiotherapy is needed. And in most cases – complex treatment. At the very least, it is necessary to undergo an examination and find out the cause of the problem. If there is an infectious process, then you cannot do without consulting specialists and taking medications that are harmful to the infectious agent. If there is arthritis, excess weight and other causes, you will have to eliminate them first. If there is a traumatic situation, then its elimination will also be beneficial and in a few months, perhaps, the inflammation will go away.

If the injury was caused by new (very beautiful) but uncomfortable shoes, then the chance to get rid of the bump is quite real. First of all, you need to stop wearing beautiful but uncomfortable shoes. Forever! If the bump appeared in the warm season, you need to choose shoes without a heel with a low heel and wear them until the cold weather sets in. Then - depending on the situation. Maybe you won't need anything else, or you'll have to choose comfortable warm shoes. If beauty is more important to you than health, then you will be treated for a long time and to no avail.

Many people are interested in how to stop the growth of cones with Achilles bursitis. Starting treatment without finding out the nature of the formation is fraught with consequences. Therefore, we take as a basis: the patient knows for sure that he has Achilles bursitis.

Shoes are important for any form of bursa inflammation. They should not injure the heel, otherwise no methods will help to cure.

You can do exercises for Achilles bursitis at home. To notice the result, you will need to do them daily for a long time:

1. Starting position: you need to rest your palms against the wall, and line up your legs with your toes behind your heels at a distance of one step (the sore leg is behind, if you have bumps on both legs, alternate the position). Slowly, squat down until you feel tension in the lower part of your shin. Hold this position for a quarter of a minute, then return to the starting position. Repeat.
2. Place a block or two thick books 5 cm high on the floor. Starting position: stand on them so that your heels hang freely. Rest your palms against the wall. Bend toward the wall until you feel tension in the lower part of your shin. Hold this position for a quarter of a minute, then return to the starting position.
3. Rise up on your toes fifteen times with both feet (if it hurts, you can hold onto the wall). If the pain is bearable, you can do the exercise fifteen times for each leg.
4. Find a cylindrical object like a rolling pin or a bottle. Sit on a chair and roll it with your bare foot along the entire arch.
5. Also, while sitting on a chair, use your toes to collect small objects of different shapes and sizes scattered on the floor in a basin (pencils, spoons, keys, balls, matches, handkerchiefs, etc.).
6. Sitting, lying or standing, bend your foot towards yourself as much as possible using your hand or a band, stretching the back surface. Hold for a quarter of a minute.

At home, with doing exercises and changing shoes, you can combine folk treatment for Achilles bursitis - smear the bumps on the heels with iodine solution, bandage a well-beaten cabbage leaf at night, make compresses with bile or Bischofite.

Cabbage leaf compress: lubricate the ankle with sunflower oil and bandage a well-beaten, fresh cabbage or burdock leaf to it so that the juice comes out. Tie a woolen scarf on top. Do this for a month, twice or three times a day, but at least at night.

Bischofite - contains minerals, mint and eucalyptus essential oils. The remedy is simply rubbed into the sore spot with the palm of the hand, then the joint is wrapped with a woolen scarf or shawl.

You can make the following composition for a compress: a standard pharmacy bottle of medical bile, two glasses of finely ground horse chestnut fruits, three crushed aloe leaves, mix and pour in two bottles of pharmacy 70% alcohol without additives (septil). Infuse for ten days. Soak a napkin made of natural fabric (linen, cotton) or gauze with the infusion, tie it around the joint, then put compress paper, cling film, a bag on top, and secure everything with a bandage or scarf. Do this for ten nights. Then repeat the course at intervals of ten days.

Herbal treatment for Achilles bursitis is also relevant, both local procedures - compresses, and taking infusions internally.

Dry burdock leaves can be used to make compresses - soak gauze or a napkin in a concentrated decoction and make a compress overnight.

Burdock root is used for internal use. A tablespoon of crushed root is boiled for five minutes in 200 ml of water, turned off and strained after ten minutes. It is necessary to drink a glass a day in three doses. Take until complete recovery.

Compresses from grated raw potatoes can cure bursitis, as healers promise, literally in one day. Such compresses should be changed every hour and a half. Before grating, the potato should be cooled in the refrigerator. The gruel from it is applied to a piece of bandage and tied to the bump.

You can also drink infusions of St. John's wort or yarrow. They are prepared in the following proportions: two tablespoons of chopped herbs are brewed with a glass of boiling water. Infuse for half an hour, filter and add boiled water in the same volume. Take half a glass three times a day for ten to twelve days. Compresses can be made from these infusions.

Homeopathy

Since anti-inflammatory joint medications have a wide range of side effects, it makes sense for everyone, and especially for those with allergies and problems with the digestive tract, to seek help from a homeopathic doctor.

In the treatment of Achilles bursitis, both acute traumatic and complications of other joint pathologies, a good effect without gross interference in physiological processes, typical for NSAIDs and glucocorticosteroids, can be achieved from homeopathic treatment.

Classical individual treatment should be prescribed by a practicing homeopath. Symptomatic remedies prescribed for inflammation of the joint capsule are Rhododendron (golden rhododendron), Benzoicum acidum (benzoic acid), Sticta pulmonaria (lung moss), Kali muriaticum or chloratum (potassium chloride), Silicea (silica), a well-known homeopathic remedy for the treatment of pathologies of the musculoskeletal system is Rhus toxicodendron (poison sumac). However, to prescribe the right homeopathic remedy, it is necessary to take into account not only the diagnosis, but also a number of other factors.

Currently, there are a number of pharmaceutical preparations on sale that are prepared according to the principle of small doses (in homeopathic dilutions). They can be prescribed by doctors of various specialties in a complex treatment regimen or as monotherapy. Thanks to such a combination, it is possible to significantly reduce the dose of hormonal or non-steroidal anti-inflammatory drugs, or even do without them altogether.

Homeopathic remedies are available in different forms – ointments, gels, ampoules for injections and oral (tablets, drops).

The complex remedy Ziel T is aimed at relieving the symptoms of joint diseases - pain syndrome, inflammation, has a pronounced regenerating effect. The formula of the drug includes 14-16 components (depending on the form) of plant (Arnica, Rhus toxicodendron, Solanum bittersweet), mineral (sulfur compounds, sodium, silicic acid), biological (placental, embryonic) origin. The combination of such active substances normalizes metabolism in the articular and cartilaginous tissue, intra-articular fluid, restores their normal structure and activity. Chronic Achilles bursitis passes with the normalization of the structure and function of the joint. The drug is also effective in collagenoses (systemic rheumatic pathologies), which sometimes result in Achilles bursitis.

The drug Ziel T is available in the form of sublingual tablets, ointment and ampoules with injection solution. Each dosage form comes with instructions for use in acute cases and for maintenance therapy. The drug is contraindicated in case of allergy to plants of the Asteraceae family or other components, although cases of hypersensitivity are extremely rare. In addition, the drug contains lactose, which should be taken into account in case of its intolerance. The injection solution and ointment are compatible with any drugs, and the decision on the advisability of taking tablets by patients simultaneously taking medications with a pronounced hepatotoxic effect is made by the attending physician.

The drug Traumeel S is not inferior in effectiveness to NSAIDs and is very popular in its home country among athletes and simply in the home medicine cabinet for use in case of injuries. It can be used for both acute and chronic Achilles bursitis. The forms of release are varied (ointment, gel, drops, tablets, injection solution) - for all cases. The drug is freely available and can be used as a first aid. It is indicated for acute and chronic inflammatory, degenerative and infectious processes. In the second case, it is recommended to combine it with the drug Ziel T. The powerful effect of Traumeel S, aimed at stopping the inflammatory process by supporting the body's own immunity, is complemented by the pronounced restorative activity of the drug Ziel T. Both drugs have the ability to relieve joint pain. Traumeel has an antiexudative ability, when applying ointment or gel to heel bumps, they quickly dissolve.

The therapeutic effect of Traumeel C is provided by calcium compounds, Hamamelis virginiana, St. John's wort, Yarrow, Aconite and Arnica - capable of strengthening the walls of blood vessels, stopping hemorrhagic effusion, and relieving edema. Homeopathic dilutions of mercury compounds complement the effects of plant substances.

Chamomile, Echinacea, Calendula, Comfrey, Hepar Sulfur activate and normalize metabolic processes at the site of injury, promoting cellular renewal and restoration of normal tissue structure.

External agents (ointment and gel) Traumeel are used at any age from birth. A thin layer of ointment can be applied to the cones two to three times a day, in acute periods - five to six applications are allowed.

It is recommended to use the gel once or twice, but in case of exacerbations it is allowed to use it more often.

Ziel T ointment is approved for use from the age of six, from two to five treatments per day, depending on the patient’s condition.

The dosage for internal and injection use should be prescribed by a doctor.

Homeopathic ointment "Arnica", a single-drug preparation, certainly does not have such a wide range of action as the previous complex remedies, but can also help in eliminating a heel bump, especially in acute cases of trauma. A thin layer of ointment is applied to the bumps two to four times a day.

After the use of complex allopathic therapy with non-steroidal drugs and steroid hormones to eliminate the effects of massive drug intoxication, cleanse the body of toxins of pathogenic agents, as well as strengthen the immune system, restore respiratory and reparative, metabolic processes and prevent relapses, Lymphomyosot, Psorinokhel N are prescribed - drugs in the form of drops for oral administration. You can use drugs that prevent hypoxic processes in tissues and metabolic disorders, Ubiquinone compositum and Coenzyme compositum. These are injectable drugs, however, the contents of the ampoules can be used for oral administration. The dose and frequency of administration are prescribed by the doctor.

Surgical treatment

In most cases, surgery for Achilles bursitis is performed in cases of purulent processes. If necessary, the abscess is opened to prevent sepsis.

Sometimes a bursa puncture is prescribed with aspiration of exudate from it followed by the introduction of antiseptics, anesthetics, antibiotics, and anti-inflammatory agents into its cavity. Such surgical manipulation has a disinfectant effect and prevents the development of relapse of inflammation.

Surgical intervention is also provided in case of ossification of the bursa. Calcifications, accumulations of salts in the bursa that interfere with the normal functioning of the joint, are removed with a special needle or by open intervention.

In advanced cases that are not amenable to conservative treatment, surgery is performed to remove the synovial bursa (bursectomy) or the heel bone.

Prevention

Sometimes the causes of inflammation in the synovial bursa near the Achilles tendon remain unclear (idiopathic Achilles bursitis). However, a number of measures can significantly reduce the likelihood of developing an inflammatory process.

Recommended:

1. Take care of your feet and choose comfortable shoes; women should choose shoes with medium heels for everyday wear.
2. In case of penetrating wounds, it is essential to treat the wound with an antiseptic as soon as possible.
3. Lead an active lifestyle, provide moderate physical activity to your joints (walking, exercise, yoga).
4. Try to avoid unusually heavy loads. Warm up your muscles before expected increased loads.
5. Eat a balanced diet and consume all the necessary substances for the normal functioning of the body.
6. Increase stress resistance, develop a positive outlook on the world, become less irritated and angry, and be more happy.
7. Try not to exceed the weight limit for your height.
8. Do not neglect chronic diseases.

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Forecast

Seeking medical attention in the acute stage of inflammation and timely treatment leads to complete recovery - gradual disappearance of inflammatory symptoms, resorption of exudate and normalization of the synovial bursa.

The prognosis for advanced disease and chronic Achilles bursitis is not so optimistic and depends on many factors. However, with a responsible attitude to your health, you can maintain your joints in working order for as long as you like.