Achilles bursitis: what is this, how to treat?

The appearance of a painful knob or swelling in the heel, a significant discomfort when walking and wearing any shoes, except flip-flops, may be a sign of inflammation of the synovial bag (bursa) located at the attachment point to the heel bone of the Achilles tendon (Achilles bursitis). Strictly speaking, there are two such bags on the back of the ankle, the tendon is protected by them from both sides - from the side of the bone (subculture) and from the outside (subcutaneous bag). They absorb the strain on the tendon, the most powerful and strongest in our body and, at the same time, the most vulnerable. Any of them can swell or both at once. The appearance of a painful tubercle on the heel is caused by overproduction and accumulation in the subcutaneous bag of synovial fluid.

[1], [2], [3]

Epidemiology

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

Back heel bursitis, as a kind of Achillobursitis, is more common in women who prefer a narrow model shoe on a high hairpin.

[4], [5], [6], [7], [8], [9],

Causes of the unsubstantiated

Achillobursitis can occur in acute and chronic form, and - the processes are divided into aseptic and purulent as a result of primary or secondary infection.

Most often, an acute inflammatory process causes permanent trauma to the calcaneus or an overload of the Achilles tendon when the person repeatedly repeats the same traumatic movement. In the risk group - people involved in sports, when the main load is the gastrocnemius muscles (skates, running, jumping, football and others); Women who prefer a narrow model high-heeled shoes; people wearing tight shoes, pressing on the heel.

Development of Achillobursitis of infectious genesis is also mainly a consequence of trauma to the subcutaneous synovial bag (puncture, cut) and infection. With a decrease in immunity, a pathogenic microorganism from a chronic foci can infect a synovial bag 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, calcaneal spur, less often - systemic scleroderma), the spread of the inflammatory process or the deposition of salts in the envelope of the synovial bag develops chronic achillobursitis.

The risk factors for development of Achillobursitis are preparation for sports competitions, overload in training, previous lack of development of muscles and ligaments, sedentary lifestyle, additional load with excess weight, elderly age.

As with any other disease, the weakening of immunity as a result of acute or chronic relapsing infections, the presence of diathesis in children and allergies in adults, autoimmune diseases, malignant processes and their therapy, and the abuse of alcohol and drugs are a serious factor that increases the likelihood of its development.

[10], [11]

Pathogenesis

Aseptic achillobursitis is the result of closed damage to the synovial bag for one of the reasons described. The walls of the bag (pocket) become inflamed - swell, they contain cellular infiltration. In the cavity appears serous (accumulation of transparent fluid), serous-fibrinous (with an admixture of fibrin protein), fibrinous or hemorrhagic effusion. The type of internal exudate depends on the severity of the inflammation and the nature of the lesions.

Inflamed bursa increases in size, on the heel grows a small knob, sometimes very large (inflammation of the subcutaneous bag, posterior calcaneal bursitis). With inflammation of only the pouch-like bag, there is no protrusion, only pain, puffiness, sometimes small, and restriction of motor activity (anterior Achilles bursitis or Albert's disease). The envelope of the bursa that increases in size presses on the surrounding tissues and nerve endings, and the effusion of the transudate occurs in the intercellular spaces.

In the primary, as a result of a penetrating injury, or secondary infection of the inside of the bag with pyogenic microorganisms, purulent inflammation develops. In most cases, infectious agents are nonspecific pathogens - staphylococci and streptococci, much less specific - gonococci, mycobacterium tuberculosis, brucella, and the like. Secondary infection of the burs from the foci of infection occurs lymphogenically. In the pathogenesis, the spread of the infection with the blood flow 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 bursal membrane and the formation of phlegmon under the skin and between the muscles. Further progression can lead to the formation of long-term healing fistulas, and getting pus in the joint pocket provokes the development of purulent arthritis.

For acute Achillobursitis traumatic genesis is characterized by the accumulation of hemorrhagic fluid in stretched bursa. Regression in this case is accompanied by the formation of fibrin up to the complete closure of the lumen of the vessels of the bursal wall. Stable structural transformations develop in it - thickening of the walls, connective tissue strands, dividing the bursal cavity into smaller parts and subsequently sprouting into nearby tissues.

In the latent period, encapsulated fossils of dead tissue or exudate remain in the shell and cavity of the bursa, which serve as the basis for another attack of inflammation in the event of repeated trauma or infection.

Chronic relapsing achillobursitis is formed as a result of prolonged and stable mechanical stimulation.

[12], [13], [14], [15], [16], [17],

Symptoms of the unsubstantiated

The first signs of trouble are discomfort when wearing shoes with a closed heel, pulling or sharp pain in the area of the heel or ankle, the strengthening of which occurs after an overnight rest. When a patient "diverges" becomes easier.

There is a slight swelling of the ankle, the appearance of a cone on the heel. With the load on the heel, the pain becomes stronger, the foot in the ankle joint turns with difficulty, the load on it responds with pain.

Stand on the socks is not possible because of the severe pain.

If you ignore the first symptoms - the process proceeds: the pain increases, the ankle reddens and swells. When the purulent process develops, the temperature rises accompanied by the symptoms of acute malaise, the pain is of a pulsating, "pulling" nature.

Inflammation can a back articular bag located between the skin and a part of the tendon that joins the calcaneus. Achillesbussis calcaneus (posterior achillobursitis) begins with a dense formation on the heel, it is very sensitive, located under the skin, as it develops reddens and more and more it hurts. The pain is localized in the heel and above it, when walking.

Another type is the Achilles bursitis of the ankle joint (anterior Achilles bursitis, Albert's disease) when the inner anterior bursa becomes inflamed. This kind of inflammation often occurs as a result of trauma (acute) or rheumatoid arthritis of the ankle (chronic). Patients complain of pain when wearing shoes with a heel, just when walking, swelling and fever in that area of the foot. First, swelling is observed in front of the tendon, without treatment - spreads around it.

Psychosomatics

Our mood, behavior and the prevalence of certain reactions and traits of character makes us more or less prone to joint diseases, including Achillesburbitis. Psychological background of diseases, their psychosomatics, has been studied for a long time and is considered by different authors. Moreover, completely different authors have drawn similar conclusions from their observations of patients. Inflammation of the joint bag, according to Louise Hay, Liz Burbo, Torsunova OG. Develop in people who are often forced to restrain their impulses of anger, aggression towards others and towards oneself. These people usually do not give vent to their emotions because of certain behavioral stereotypes that do not allow them to relax, make them restrain emotions, which contributes to the accumulation of grievances and disappointments.

A patient suffering from bursitis is usually a very demanding person, primarily to himself, striving for excellence even in the most insignificant cases. Accordingly, he accumulates resentment and irritation on "imperfect" relatives, colleagues who do not meet such high standards and, moreover, are not able to assess his high level and achievements. He accumulates anger in them, which, nevertheless, does not allow himself to manifest. Also accumulates and anger at himself, he can not accept and fall in love with himself, such as he is. These are people who play the role of a victim in life or are completely opposite, prone to tyranny. In any case, he feels overwhelming self-pity, which develops against the backdrop of suppressed bursts of rage caused by an unjust (as it seems to him) attitude towards him, desires to punish offenders.

Cumulated anger in the joint associated with the situation (if you want to hit with your hand - in the joint of the arm, leg - in the joints of the lower limb). Achillobusset reminds the patient that the situation should not be aggravated and delayed. Also does not mean that you need to discharge it by striking someone. Need to quickly voice their claims 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 revising your priorities. Such people need to learn how to communicate effectively with other people, not to show them excessive demands, and also learn to love themselves and relax, forgiving themselves for some weaknesses and with optimism perceiving the environment.

Complications and consequences

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

The lack of treatment and continued injury to the articular bags leads to complications - the proliferation of scar tissue continues, which leads to limitations on the mobility of the joint.

Calcification or development in the fibrinous modified shell of the articular bag of the sites of ossification leads to ossification or calcic dystrophy (petrification).

Complication of the posterior stump bursitis can be deformity of Haglund (bone growth on the back of the calcaneus) or rupture of the Achilles tendon.

It can develop purulent complications of abscess, fistula, sepsis, necrosis of the tissues of the synovial bag, purulent arthritis of the ankle, persistent impairment of its mobility, osteomyelitis of the lower leg, lymphadenopathy.

[18], [19], [20], [21], [22], [23], [24], [25],

Diagnostics of the unsubstantiated

After the conversation and examination of the patient, the doctor prescribes tests:

• a clinical blood test will help determine the presence of the inflammatory process and its intensity by the number of leukocytes and the rate of erythrocyte sedimentation;
• when suspected of specific infections, serological tests are assigned to identify antibodies and antigens to infectious agents;
• Immunological tests are done in case of suspected allergic origin of the disease;
• revmoproby - for the presence of rheumatism;
• bacteriological study of the contents of the bursa obtained by puncturing.

The most commonly prescribed instrumental diagnosis is an ankle x-ray (usually in two projections) and ultrasound. Through ultrasound, it is possible to visualize the inflamed bursa, its size and contents (blood, pus, calcifications) on a computer monitor.

If necessary, can appoint a magnetic resonance or computed tomography, although because of the high cost of research, it is rarely resorted to. Usually, two previous ones are sufficient to establish the diagnosis.

Differential diagnosis

Differential diagnosis is conducted between aseptic and purulent inflammation, the causative agent of infection is determined. Also, differentiation is carried out with a rupture of the Achilles tendon, Haglund deformity, heel spur, enthesopathy and Achilles tendon xanthoma, fracture of the lateral tubercle of the posterior appendix of the calcaneus, erosive changes resulting from rheumatoid arthritis.

[26], [27], [28], [29], [30], [31], [32], [33],

Treatment of the unsubstantiated

First of all, they try to ensure, as much as possible, that the heel does not irritate the back of the shoes (with the help of pads under the heel, pads, orthoses and other orthopedic devices). The footwear of the patient should be on a low heel, comfortable and spacious (preferably orthopedic), if possible without a heel.

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

Local treatment is carried out with the use of ointment. Sometimes such measures are enough.

For example, in the treatment of achillobursitis, compresses with Dimexide solution or application of this drug to a sore spot in the form of a gel can be prescribed. The active substance of this agent is dimethylsulfoxide. This medicine has the ability to quell the pain syndrome at the site of application, while also having 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 5cm). In combination with novocaine (lidocaine), it increases the analgesic effect, with hydrocortisone - anti-inflammatory, with antibiotics - enhances their effectiveness, reducing the resistance of bacteria to them (so it is used in purulent achillobourtse).

In case of aseptic achillobursitis, such a compress can help: dilute 15ml of dimexide (30-50%) into 75ml of boiled water and add one ampoule of hydrocortisone (Prednisolone, Dexamethasone) and 20-30ml of lidocaine to the solution. Keep such a compress should not 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 from the solution of Dimeside in water on top.

Dimexide is toxic, therefore it can be applied even locally in the form of an aqueous solution or as a gel (ointment). He himself belongs to the NSAID group, so the use in combination with the drugs of the same group mutually reinforces the overall effect. It is contraindicated for pregnant and lactating women, people with heart disease, liver and kidneys, with glaucoma, children until the age of four. Allergy sufferers should, before applying this substance, conduct a test for sensitivity.

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

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

Improve blood circulation in soft tissues, reduce pain and inflammation as well as ointments based on snake (Viprosal B) and bee (Apisatron) venom.

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

Ointment Apisatron has multifaceted medicinal properties, due to the presence of bee venom in it. Synergically with it, other components - methyl salicylate, which has a good penetrating ability, complement the anti-inflammatory effect, alizolythiocyanate improves microcirculation and, therefore, cellular respiration and metabolic processes. Ointment is also not recommended for use by pregnant and lactating women, and persons with severe renal / hepatic insufficiency. It is used twice or thrice a day, rubbed into cones.

Both ointments do not apply to damaged skin, do not allow them to get on mucous membranes. After treatment - wash your hands well with soap and water.

As local procedures, injections with achillobourtish may be prescribed. The injection is made directly into the inflamed bursa. So inject painkillers, NSAIDs. Such a method allows avoiding complications on the gastrointestinal tract from oral administration of non-steroidal anti-inflammatory drugs (at least to reduce the ingested dose). In the absence of effect in the case of aseptic inflammation, the method of aspirating the contents of the bursa and introducing a long-acting glucocorticosteroid in combination with an anesthetic is used. In the presence of infection, it is supplemented with an appropriate antibiotic.

In tablets or injections, non-steroidal anti-inflammatory drugs are prescribed, relieving pain syndrome and stopping the symptoms of inflammation. In resistant cases, systemic therapy with corticosteroids is administered, when specific infections (eg, tuberculosis) are detected, patients undergo appropriate therapy.

In the treatment of achillobursitis, agents that enhance the patient's immunity are also used. More often - it's vitamin complexes, which contain vitamins C, A, Group B, immunostimulants can also be prescribed. Physiotherapy is widely used. Electrophoresis in achillobursitis 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 in achillobiscus includes the normalization of metabolic processes in the ankle and the strengthening of the synthesis of endogenous bioactive substances, vasodilation and activation of blood flow, as well as improvement of lymph drainage, relief of pain and inflammation. Usually the therapeutic course includes ten to fifteen daily procedures.

Shockwave therapy is considered to be no less effective in Achillesbury. The effect with its help is achieved quickly enough. The meaning of the procedure is the impact on the affected area of infrasound - sound low-frequency waves. They penetrate well into the bursa and contribute to the repair processes in its cavity. The blood circulation in the vessels of the bursal wall improves, the amount of synovial fluid in the bag cavity decreases, the quality and metabolic processes in the envelope are normalized. External changes are visible in the reduction of pain, reduction of edema, restoration of joint mobility. The procedure is contraindicated in patients with varicose veins, embrittlement and high permeability of vessels, as well as with skin pathologies, hepatic / renal insufficiency, neoplasms and diabetes mellitus.

It is used to treat achillobursitis therapy with laser and ultraviolet light, high frequency electromagnetic fields, ultrasound, paraffin and ozocerite heating, cryotherapy, hirudotherapy, mud therapy. In chronic inflammation, x-ray irradiation of the affected joint is practiced.

Acupuncture can be prescribed, which gives a good effect with aseptic achillobourt.

How to treat ahillobursit at home?

Experts say that it is impossible to get rid of achillobursitis by home methods, at least physiotherapy is needed. And in most cases - complex treatment. At least, to be surveyed and to find out the reason of trouble necessarily it is necessary. If there is an infectious process, then without consulting specialists and drugs, harmful to the infectious agent can not do. In the presence of arthritis, excess weight and other reasons, to eliminate in the first place, they will have to. If there is a traumatic situation, its exclusion will also benefit and in a few months, perhaps, inflammation will also pass.

In case the injury is obtained from a new (very beautiful), but uncomfortable shoes, then the chance to get rid of the cones is quite real. First of all, you need to stop wearing beautiful, but uncomfortable shoes. Forever! If the bump appeared in the warm season, it is necessary to choose shoes without a heel on a low stroke and wear it before the onset of colds. Next - on the situation. Maybe you will not need anything anymore, or you'll have to pick up comfortable warm shoes. If beauty is more important to you than health, then you will be treated in all ways for a long time and to no avail.

Many are interested in how to stop the growth of cones in Achillesbury. To take care of the treatment without knowing the nature of education is fraught with consequences. Therefore, we take as a basis: the patient knows for sure that he has achillobursitis.

Shoes with any form of inflammation of the bursa is important. She should not injure the heel, without this no methods will not help to heal.

At home, you can do exercises with Achilles. To notice the result, they need daily execution for a long time:

1. Starting position: palms should be resting against the wall, and legs should be put in one line of the sock behind the heel at a distance of a step (the diseased leg is behind, if the bumps on both legs alternate position). Without hurrying, we squat down to the sensation of the tension of the lower part of the shank. Fix in this position for a quarter of a minute, then return to the ip. Repeat.
2. Put on the floor a beam or two thick books 5cm high. Starting position: stand on them so that the heels hang freely. Hand against the wall. Do the slopes in the direction of the wall until you feel the tension of the lower leg. Fix in this position for a quarter of a minute, then return to the i.p.
3. Fifteen times to rise on the toes with both feet (if it hurts, you can stick to the wall). With tolerable pain, you can do an exercise for each leg fifteen times.
4. Find a cylindrical object such as a rolling pin or a bottle. Sit on a chair and roll it barefoot along the entire arch.
5. Also, sitting on a chair, gather small pieces of different shapes and sizes scattered on the floor (pencils, spoons, keys, balls, matches, scarves, etc.) scattered on the floor into the basin with your toes.
6. Sitting, lying or standing as much as possible to bend a foot on itself with a hand or a tape, having stretched a back surface. Fix for a quarter of a minute.

At home, with exercises and changing shoes, you can combine the folk treatment of Achillobursitis - smear the tubercles on the heels with a solution of iodine, pribintovyvat for the night a well-sprouted cabbage leaf, make compresses with bile or Bishofit.

Compress with a cabbage leaf: lubricate the ankle with sunflower oil and pribintovat to it well-beaten, so that the juice, a fresh leaf from cabbage or burdock. Top with a woolen scarf. Do this for a month, you can twice or thrice a day, but at least for the night.

Bishofit - contains minerals, mint and eucalyptus essential oils. The agent simply rubs the palm in a sore spot, then wraps the joint with a woolen shawl or scarf.

You can make the following composition for a compress: a standard medical bottle of medical bile, two glasses of horse chestnut fruit of a fine fraction, three crushed aloe leaf, stir and pour two bottles of 70% alcohol without additives (septile). Insist ten days. Saturate with a napkin made of natural fabric (linen, cotton) or gauze, tie the joint, on top - compress paper, food film, bag, all secure with a bandage, scarf. Do this for ten nights. Then, with an interval of ten days, the course is repeated.

Treatment with herbs in Achilles burgundia is also relevant, as are local procedures - compresses, and ingestion of infusions inside.

Dry burdock leaves can be used to make compresses - concentrate a decoction of them soaked gauze or a napkin and make a compress for the night.

For internal use use the root of burdock. A tablespoon of the crushed root is boiled for five minutes in 200ml of water, turned off and after ten minutes it is filtered. It is necessary to drink a glass a day in three divided doses. Take until complete cure.

Compresses from grated raw potatoes can cure bursitis, as the healers promise, literally in one day. Change these compresses every hour and a half. The potato must be cooled in the refrigerator before rubbing. Kashitsu from it put on a piece of bandage and tied to a bump.

You can also drink infusions from the herb of St. John's wort or yarrow. Prepare them in the proportions: two tablespoons of chopped herbs brewed a glass of boiling water. Insist half an hour, filter and add boiled water in the same volume. Take half a cup three times a day from ten to twelve days. You can make compresses from these infusions.

Homeopathy

Since anti-inflammatory articular medications have a wide range of side effects, it is worthwhile for everyone, especially allergy sufferers and people with a distressing digestive tract, to seek help from a homeopathic doctor.

In the treatment of Achillobursitis, both acute traumatic and complications of other articular pathologies, a good effect without gross interference in the physiological processes characteristic of NVS and glucocorticosteroids can be from homeopathy treatment.

Classical individual treatment should appoint a practicing homeopath. Symptomatic drugs prescribed for inflammation of the joint bag are Rhododendron (golden rhododendron), Benzoicum acidum (benzoic acid), Sticta pulmonaria (pulmonary moss), Kali muriaticum or chloratum (potassium chloride), Silicea (silica), a widely known homeopathic remedy pathologies of the musculoskeletal system is Rhus toxicodendron (poisonous sumac). However, to determine the correct homeopathic remedy, it is necessary to take into account not only the diagnosis, but also a number of other factors.

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

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

Complex means The purpose of T is aimed at alleviating the symptoms of joint diseases - pain syndrome, inflammation, has a pronounced regenerative effect. The formula of the preparation includes 14-16 components (depending on the form) of the plant (Arnika, Rus toxicodenadron, Nostalgia bitter-sweet), mineral (sulfur compounds, sodium, silicic acid), biological (placental, embryonic) origin. The aggregate of such active substances normalizes metabolism in articular and cartilaginous tissues, intraarticular fluid, restores their normal structure and activity. Chronic Achilles bursitis passes with the normalization of the structure and work of the joint. The drug is also effective in collagenoses (systemic rheumatic pathologies), the consequence of which is sometimes achillobursitis.

The form of the preparation of the preparation of Objective T are tablets for resorption under the tongue, ointment and ampoules with an injection solution. Each dosage form is accompanied by instructions for use in acute cases and with maintenance therapy. Contraindicated drug for allergy to plants of the family Compositae or other components, although cases of hypersensitivity are extremely rare. In addition, the preparation contains lactose, which should be taken into account when it is intolerant. Solution for injection and ointment are compatible with any medications, and the decision on the advisability of taking tablets by patients who simultaneously take medication with a pronounced hepatotoxic effect is taken by the attending physician.

The drug Traumeel C is not inferior in effectiveness to NSAIDs and is very popular at home in athletes and just in the home medicine chest for use in trauma. It can be used in both acute and chronic Achilles. The forms of release are various (ointment, gel, drops, tablets, injection solution) - for all cases. The drug is available for free sale 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 preparation of Objective T. The powerful effect of Traumeel C, aimed at arresting the inflammatory process by supporting its own immunity, is supplemented by the pronounced restorative activity of the drug. Objective T. Both drugs have the ability to alleviate joint pain. Traumeel has an anexexcellent ability, when applying ointment or gel on the heel bumps, they quickly resolve.

Therapeutic effect of Traumeel C is provided by calcium compounds, Hamamelis virgin, St. John's wort, Yarrow, Aconite and Arnica - able to strengthen the walls of blood vessels, stop hemorrhagic effusion, and remove swelling. Homeopathic dilutions of mercury compounds supplement the effects of plant substances.

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

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

The gel is recommended to be used once or twice, but with exacerbations it is allowed to apply more often.

Ointment The purpose of T is allowed to use from the age of six, from two to five treatments per day depending on the condition of the patient.

Dosage for internal and injective use should be prescribed by a physician.

Homeopathic ointment Arnika, a mono-drug that certainly does not have such a wide range of activities as previous complex agents, but it can also help in eliminating cones on the heel, especially in acute cases of trauma consequences. A thin layer of ointment is applied to the cones from two to four times a day.

After the use of complex allopathic therapy with non-steroidal preparations and steroid hormones, Lymphomyosot, Psorinochel H-preparations in the form of lymphomas are prescribed for the elimination of the consequences of massive drug intoxication, purification of the organism from toxins of pathogenic agents, as well as strengthening of protective forces, recovery of respiratory and reparative, metabolic processes and prevention of relapses. Drops for oral administration. You can use drugs that interfere with hypoxic processes in tissues and metabolic disorders, Ubiquinone compositum and Coenzyme compositum. These are injectable medicines, however, the contents of the ampoules can be used for oral administration. Doses and the frequency of reception are prescribed by the doctor.

Surgery

Operation with achillobourtish in most cases is carried out with purulent processes. If necessary, in order to prevent sepsis, an autopsy is performed.

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

Surgical intervention is also envisaged in the case of ossification of the bursa. Calcinates, accumulations of salts in the bag, interfering with the normal operation of the joint, are extracted with a special needle or with the help of an open intervention.

In advanced cases, not subject to conservative treatment, is an operation to remove the synovial bag (bursectomy) or calcaneus.

Prevention

Sometimes the reasons for the development of inflammation in the synovial bag near the Achilles tendon remain unclear (idiopathic achillobursitis). However, a number of measures can significantly reduce the likelihood of the development of the inflammatory process.

Recommended:

1. Protect your feet and choose comfortable shoes, women for everyday wear choose shoes on the middle heel.
2. With penetrating wounds, it is necessary to treat the wound as soon as possible with an antiseptic.
3. To lead an active way of life, to give moderate physical load on joints (walks, gymnastics, yoga).
4. Try not to allow unusually heavy loads. Before the supposed increased loads, "warm up" the muscles.
5. It is good to eat, eat with food all the necessary substances for the normal functioning of the body.
6. Increase stress resistance, develop a positive outlook on the world, less irritated, angry and enjoy more.
7. Try not to exceed the allowable weight for your height.
8. Do not run chronic diseases.

[34], [35]

Forecast

Addressing a doctor in the acute stage of inflammation and timely treatment leads to a complete recovery - the gradual disappearance of inflammatory symptoms, resorption of exudate and normalization of the synovial bag.

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