Calcaneal Bursitis Medication

  • Author: Patrick M Foye, MD; Chief Editor: Consuelo T Lorenzo, MD   more...
 
Updated: Aug 31, 2010
 

Medication Summary

For this musculoskeletal condition, medications are used primarily to decrease pain and inflammation. Thus, the most commonly used medications are oral nonsteroidal anti-inflammatory drugs (NSAIDs), which are employed in conjunction with the rest of the rehabilitation plan.[14]

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Nonsteroidal anti-inflammatory drugs

Class Summary

Oral NSAIDs can help to decrease pain and inflammation. Various oral NSAIDs can be used, with the choice of drug being largely a matter of convenience (how frequently doses must be taken to achieve adequate analgesic and anti-inflammatory effects) and cost.

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Ibuprofen (Motrin, Advil, Nuprin, Rufen)

 

DOC for patients with mild to moderate pain. Inhibits inflammatory reactions and pain by decreasing prostaglandin synthesis. Various doses are available with and without a prescription.

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Naproxen (Naprelan, Naprosyn, Aleve, Anaprox)

 

For relief of mild to moderate pain; inhibits inflammatory reactions and pain by decreasing the activity of cyclo-oxygenase, which results in a decrease of prostaglandin synthesis.

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Ketoprofen (Actron, Orudis, Oruvail)

 

For relief of mild to moderate pain and inflammation.

Small dosages are initially indicated in small and elderly patients and in persons with renal or liver disease. Doses over 75 mg do not increase therapeutic effects. Administer high doses with caution and closely observe patient for response.

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Flurbiprofen (Ansaid)

 

May inhibit cyclo-oxygenase enzyme, which in turn inhibits prostaglandin biosynthesis. These effects may result in analgesic, antipyretic, and anti-inflammatory activities.

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Nonsteroidal Anti-inflammatory Drug, Topical

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Diclofenac topical

 

DOC for patients with mild to moderate pain. Inhibits inflammatory reactions and pain by decreasing prostaglandin synthesis.

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Contributor Information and Disclosures
Author

Patrick M Foye, MD  Associate Professor of Physical Medicine and Rehabilitation, Co-Director of Musculoskeletal Fellowship, Co-Director of Back Pain Clinic, Director of Coccyx Pain Service (Tailbone Pain Service: www.TailboneDoctor.com), University of Medicine and Dentistry of New Jersey, New Jersey Medical School

Patrick M Foye, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine, Association of Academic Physiatrists, and International Spine Intervention Society

Disclosure: Nothing to disclose.

Coauthor(s)

Todd P Stitik, MD  Professor, Department of Physical Medicine and Rehabilitation; Director, Outpatient Occupational/Musculoskeletal Medicine, UMDNJ-New Jersey School of Medicine

Todd P Stitik, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, Association of Academic Physiatrists, Phi Beta Kappa, and Physiatric Association of Spine, Sports and Occupational Rehabilitation

Disclosure: Nothing to disclose.

Specialty Editor Board

Daniel D Scott, MD, MA  Associate Professor, Department of Physical Medicine and Rehabilitation, University of Colorado School of Medicine; Attending Physician, Department of Physical Medicine and Rehabilitation, Denver Veterans Affairs Medical Center, Eastern Colorado Health Care System

Daniel D Scott, MD, MA is a member of the following medical societies: Alpha Omega Alpha, American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine, American Paraplegia Society, Association of Academic Physiatrists, National Multiple Sclerosis Society, and Physiatric Association of Spine, Sports and Occupational Rehabilitation

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Senior Pharmacy Editor, eMedicine

Disclosure: eMedicine Salary Employment

Michael T Andary, MD, MS  Professor, Residency Program Director, Department of Physical Medicine and Rehabilitation, Michigan State University College of Osteopathic Medicine

Michael T Andary, MD, MS is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular and Electrodiagnostic Medicine, American Medical Association, and Association of Academic Physiatrists

Disclosure: allergan Honoraria Speaking and teaching; Pfizer Honoraria Speaking and teaching

Kelly L Allen, MD  Medical Director, Medevals

Disclosure: Nothing to disclose.

Chief Editor

Consuelo T Lorenzo, MD  Consulting Staff, Department of Physical Medicine and Rehabilitation, Alegent Health, Immanuel Rehabilitation Center

Consuelo T Lorenzo, MD is a member of the following medical societies: American Academy of Physical Medicine and Rehabilitation

Disclosure: Nothing to disclose.

References

  1. Brinker MR, Miller MD. The adult foot. In: Fundamentals of Orthopaedics. Philadelphia, Pa: WB Saunders; 1999:342-63.

  2. Foot and ankle. In: Snider RK, ed. Essentials of Musculoskeletal Care. Rosemont, Ill: American Academy of Orthopaedic Surgeons; 1997:366-489.

  3. McGee DJ. Lower leg, ankle, and foot. In: Orthopedic Physical Assessment. 2nd ed. Philadelphia, Pa: WB Saunders; 1992:448-515.

  4. Kachlik D, Baca V, Cepelik M, et al. Clinical anatomy of the retrocalcaneal bursa. Surg Radiol Anat. Mar 11 2008;[Medline].

  5. Teebagy AK. Leg and ankle. In: Steinberg GG, Akins CM, Baran DT, eds. Orthopaedics in Primary Care. 3rd ed. Baltimore, Md: Lippincott Williams & Wilkins; 1999:241-67.

  6. Young JL, Olsen NK, Press JM. Musculoskeletal disorders of the lower limbs. In: Braddom RL, ed. Physical Medicine and Rehabilitation. Philadelphia, Pa: WB Saunders; 1996:783-812.

  7. Aldridge T. Diagnosing heel pain in adults. Am Fam Physician. Jul 15 2004;70(2):332-8. [Medline]. [Full Text].

  8. Eshed I, Althoff CE, Feist E, et al. Magnetic resonance imaging of hindfoot involvement in patients with spondyloarthritides: comparison of low-field and high-field strength units. Eur J Radiol. Jan 2008;65(1):140-7. [Medline].

  9. Erdem CZ, Tekin NS, Sarikaya S, et al. MR imaging features of foot involvement in patients with psoriasis. Eur J Radiol. Nov 8 2007;[Medline].

  10. Reiter M, Ulreich N, Dirisamer A, et al. [Extended field-of-view sonography in Achilles tendon disease: a comparison with MR imaging]. Rofo. May 2004;176(5):704-8. [Medline].

  11. Sofka CM, Adler RS, Positano R, et al. Haglund's syndrome: diagnosis and treatment using sonography. HSS J. Feb 2006;2(1):27-9.

  12. Olsen NK, Press JM, Young JL. Bursal injections. In: Lennard TA, ed. Physiatric Procedures in Clinical Practice. Philadelphia, Pa: Hanley & Belfus; 1995:36-43.

  13. Ortmann FW, McBryde AM. Endoscopic bony and soft-tissue decompression of the retrocalcaneal space for the treatment of Haglund deformity and retrocalcaneal bursitis. Foot Ankle Int. Feb 2007;28(2):149-53. [Medline].

  14. Nonsteroidal anti-inflammatory drugs (NSAIDs). In: Green SM, ed. Tarascon Pocket Pharmacopoeia 2000. Loma Linda, Calif: Tarascon Pub; 2000:11-2.

  15. Ly JQ, Bui-Mansfield LT. Anatomy of and abnormalities associated with Kager's fat Pad. AJR Am J Roentgenol. Jan 2004;182(1):147-54. [Medline].

  16. Reiter M, Ulreich N, Dirisamer A, Tscholakoff D, Bucek RA. Extended field-of-view sonography in Achilles tendon disease: a comparison with MR imaging. Rofo. 2004;176:704-708.

 
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Achilles stretch 1; whole-person view. The patient stands with the affected foot flat on the floor and leans forward toward the wall until a gentle stretch is felt in the ipsilateral Achilles tendon. The stretch is maintained for 20-60 seconds and then is relaxed.
Achilles stretch 1; cropped view showing a close-up of the region affected by this type of stretch.
Achilles stretch 2; whole person view. This stretch, which is somewhat more advanced than that shown in Images 1-2, isolates the Achilles tendon. It is held for at least 20-30 seconds and then is relaxed.
Achilles stretch 2; close-up view.
 
 
 
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