The foot and ankle contain several fluid-filled sacs called bursae that help cushion and lubricate the bones, muscles, and tendons. Ankle bursitis refers to a condition where one or more of the bursae become inflamed, causing constant pain and redness of the skin. Most cases of ankle bursitis are the result of overuse and repetitive strain during sports or other physical activities. Mild bursitis can usually be treated at home by resting and icing the joint for several days, although chronic ankle pain should be evaluated and treated by a doctor.
The 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 inflamed. Various bursae can be affected in the foot and ankle, although the most common site of inflammation is the retrocalcaneal bursa between the Achilles tendon and the heel bone. The back of the heel is often 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 must frequently walk, reach, and kneel to perform tasks. When the ankles are put under intense stress on a regular basis, as is common in track and basketball, the friction between the muscles, tendons, and bones overwhelms the bursae, leading to inflammation. The condition can worsen if a person wears shoes that are too tight and do not provide enough padding in the heel and ankle areas. Also, improper stretching before physical activity can greatly increase the risk of ankle bursitis and other injuries.
Medical experts strongly recommend that people report any symptoms of ankle pain to their doctors, even if they are mild. The earlier ankle bursitis is discovered, the easier it is to remedy. A doctor may perform a physical exam and ask the patient about their symptoms to make a proper diagnosis. If a serious condition is suspected, the doctor may decide to do an MRI scan to see the extent of bursa damage.
A patient with mild bursitis is usually instructed to avoid strenuous activity, rest the ankle as much as possible, and apply an ice pack regularly to relieve pain and swelling. Over-the-counter anti-inflammatory medications can further help reduce symptoms. With proper care, bursitis tends to resolve in less than a 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 swelling. Your doctor may prescribe pain medication and place your ankle in a brace or cast to keep it immobile during the healing phase. Every few weeks, the doctor may evaluate the ankle and arrange for physical therapy to help the patient regain strength and flexibility. In rare cases, bursitis can be severe enough to require surgery to remove the affected bursa.