Ultrasound-Guided Cortisone Injections for Heel Bursitis

 

Introduction

Heel bursitis is an inflammatory condition affecting the bursae located around the heel, leading to pain and discomfort. At Joint Injections, we offer ultrasound-guided cortisone injections as a targeted approach to manage this condition. This blog provides a comprehensive overview of heel bursitis, its anatomy, pathology, and the role of cortisone injections in its management.

Understanding Heel Bursitis

Anatomy of the Heel

The heel comprises various structures, including bones, tendons, and bursae. The primary bursae associated with heel bursitis are:

  • Retrocalcaneal Bursa: Located between the Achilles tendon and the calcaneus (heel bone), it facilitates smooth movement of the tendon over the bone.
  • Subcutaneous Calcaneal Bursa: Positioned between the skin and the Achilles tendon, it reduces friction between the skin and the tendon.

Pathology of Heel Bursitis

Heel bursitis involves inflammation of the bursae, leading to pain and swelling. Factors contributing to this condition include:

  • Overuse: Repetitive stress from activities like running can irritate the bursae.
  • Footwear: Ill-fitting shoes can exert pressure on the heel, causing inflammation.
  • Anatomical Variations: Conditions like Haglund’s deformity, a bony enlargement on the back of the heel, can predispose individuals to bursitis.
  • Systemic Conditions: Inflammatory diseases such as rheumatoid arthritis can also lead to bursitis.

Clinical Presentation

Patients with heel bursitis may experience:

  • Pain at the back of the heel, especially during activities.
  • Swelling and redness over the affected area.
  • Tenderness upon palpation.
  • Difficulty wearing certain types of footwear.

Diagnosis

Diagnosis involves a combination of clinical evaluation and imaging studies:

  • Clinical Examination: Assessing the location and nature of the pain.
  • Imaging:
  • Ultrasound: Useful for visualising the inflamed bursa and guiding injections.

Management Strategies

Conservative Treatments

Initial management includes:

  • Rest: Reducing activities that exacerbate symptoms.
  • Ice Therapy: Applying ice packs to reduce inflammation.
  • Footwear Modification: Using shoes with proper support to alleviate pressure.

Cortisone Injections

When conservative measures are insufficient, cortisone injections may be considered.

Mechanism of Action

Cortisone is a corticosteroid that reduces inflammation by:

  • Inhibiting the release of inflammatory mediators.
  • Suppressing immune responses that contribute to inflammation.
  • Decreasing capillary permeability, thereby reducing swelling.

Ultrasound-Guided Technique

Utilising ultrasound guidance ensures precise delivery of cortisone into the inflamed bursa, enhancing efficacy and minimising risks.

Procedure Overview

  1. Preparation: The area is sterilised, and local anaesthesia may be administered.
  2. Imaging: Ultrasound is used to locate the inflamed bursa.
  3. Injection: A needle is guided into the bursa under ultrasound, and cortisone is injected.
  4. Post-Procedure Care: Patients are advised to rest and monitor for any adverse reactions.

Considerations and Precautions

  • Infection Risk: As with any injection, there is a minimal risk of infection.
  • Tendon Integrity: Care is taken to avoid injecting into the tendon to prevent weakening.
  • Repeat Injections: The frequency of cortisone injections is limited to avoid potential side effects.

Role of Joint Injections

At Joint Injections, we prioritise patient safety and treatment efficacy. Our approach includes:

  • Comprehensive Assessment: Evaluating the patient’s condition thoroughly before recommending injections.
  • Ultrasound Guidance: Ensuring accurate delivery of medication.
  • Personalised Care: Tailoring treatment plans to individual needs.

Conclusion

Heel bursitis can significantly impact daily activities, but with appropriate management, symptoms can be alleviated. Ultrasound-guided cortisone injections offer a targeted approach to reduce inflammation and pain. At Joint Injections, we are committed to providing precise and effective treatments to support our patients’ well-being.

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