The foot and ankle contain several fluid-filled sacs called bursae that help to cushion and lubricate bones, muscles, and tendons. Ankle bursitis refers to a condition in which one or more of the bursae become inflamed, leading to constant pain and skin redness. Most cases of ankle bursitis result from repetitive overuse and exertion during sports or other physical activities. Mild bursitis can usually be treated at home by resting and icing the joint for several days, though chronic ankle pain needs to be assessed and treated by a physician.
Bursae are made up of membrane linings and synovial fluid, a thick substance that provides protection and reduces friction between moving parts. Bursitis occurs when the lining of a bursa becomes irritated and swollen. Several bursae can be affected in the foot and ankle, though the most common site of inflammation is the retrocalcaneal bursa between the Achilles tendon and the heel bone. The back of the heel is usually tender to the touch and the skin may be red and warm. A person is likely to have chronic pain that worsens during and after physical activity.
Ankle bursitis is most common in athletes and workers who are required to frequently walk, stretch, and kneel to perform tasks. When the ankles are subjected to intense strain on a regular basis, as is common in track and basketball, the friction between muscles, tendons, and bones overwhelms the bursae and leads to inflammation. The condition can be worsened if an individual wears shoes that are too tight and do not provide sufficient padding in the heel and ankle areas. In addition, inadequate stretching before physical activity can greatly increase the risk of ankle bursitis and other injuries.
Medical experts strongly recommend people report any symptoms of ankle pain to their physicians, even if they are mild. The earlier ankle bursitis is discovered, the easier it is to remedy. A doctor can conduct a physical examination and ask the patient about his or her symptoms to make a proper diagnosis. If a serious condition is suspected, the doctor may decide to conduct a magnetic resonance imaging scan to view the extent of bursa damage.
A patient with minor bursitis is typically instructed to avoid intense activity, rest the ankle as much as possible, and apply an ice pack regularly to ease pain and swelling. Over-the-counter anti-inflammatory medications can further help reduce symptoms. With proper care, bursitis tends to be resolved in less than one month.
In a more severe case of ankle bursitis, a doctor may decide to inject a corticosteroid solution directly into the ankle to immediately reduce inflammation. The physician can prescribe pain medication and place the ankle in a brace or cast to keep it immobile during the healing phase. Every few weeks, the doctor can assess the ankle and arrange for physical therapy to help the patient regain strength and flexibility. In rare cases, bursitis can be bad enough to necessitate surgery to remove the afflicted bursa.