Bursitis of the feet and heels

Bursas are small fluid containing sacs, that are situated between areas of high friction such as bone against the floor (heel) and bone against other soft tissue structures like tendons, skin and or muscle.
The bursa job is to act as a shock absorber, and to allow stress free movement between the above noted structures. Bursitis is a swelling\inflammation of the bursa sac, due to constant micro trauma or overuse. In the foot Abnormal Pronation, most often caused by Morton’s Toe, is the leading cause of this overuse. It is most commonly found on the foot, at the bottom (Heel Spur) and back of the heel bone; and underneath the metatarsal heads going toward the toes.

As I wrote in my book  Why You Really Hurt: It All Starts In The Foot about heel bursitis

Heel Bursitis

A bursa is a fluid-containing sac that is present at many areas of pressure on the body. Its job is to protect these areas of pressure by being a shock absorber. A bursitis is an abnormal inflammation of the bursa sac caused by abnormal excessive pressure, stress and/ or strain over the area it is protecting. On the heel bone, there are two bursa sacs: one on the bottom and the other on the back. Specifically on the bottom of the heel, it is known as an Inferior (bottom) Calcaneal (heel) Bursa. On the back of the heel, it is called the Retro (back) Calcaneal Bursa.

When either of these bursas become abnormally stressed, strained, or swollen, the result is bursitis of the heel. It is this bursitis that is the reason for pain in the heel upon arising (Poststatic Dyskinesia) in the morning or after resting for a while. You can either develop these bursitises  with or without the presence of heel spur (explanation to follow). As stated before, Morton’s Toe can cause this by causing over pronation in the foot.

Metatarsalgia can also be caused by a bursitis. The big toe or Bunion joint is also a favorite spot to find bursitis in the foot. Bursitis is confused with Gout and infection by those who don’t deal with them on a daily basis. The most common complaint from the patient is upon rising in the morning, or after about 20 minutes or resting, then upon rising, there is great pain in the area of the bursa. This is due to the fact that the fluid in the sac has hardened up and can not flow as easy as it did, that is what is causing the pain.
As with all foot problems, we choose first to treat Bursitis conservatively with the use of Physical Therapy and padding and strappings, and Orthotics. We have found that most (over 90%) patients’ problems are resolved by using this treatment protocol.

Dr. Burton S. Schuler is a Podiatrist,  foot specialist of Panama City, Fl and the director of the Ambulatory Foot Clinics Podiatric Pain Management Center. He is a leading authority on the Morton’s Toe Long Second Toe and it associated problems. He is the author of the newly published book about The Morton’s Toe, Why You Really Hurt: It All Starts In the Foot. The book is disturbed national by the Cardinal Publishing Group. It will be translated to Greek this Year.

Dr. Schuler, graduated from the N. Y. College of Podiatric Medicine in 1975 at the age of twenty-four, and has been in private practice ever since. In 1982, he published his first book, The Agony of De-Feet: A Podiatrist Guide to Foot Care. During his thirty-five year professional career, he has written for Collier’s Encyclopedia and various podiatric journals and publications. He has been interviewed by The New York Times, First in Women, and many other publications. Dr. Schuler has appeared on hundreds of radio  shows