in The ANRF Chronicle
An enthesis is the point at which a tendon or ligament attaches to the bone. If inflammation occurs at this connection point, the condition is known as enthesitis. The point at which the Achilles’ tendon inserts to the back of the foot and the point at which the fascia inserts at the bottom of the heel are two of the most common areas affected by the condition. Generally, the condition only occurs with certain types of arthritis and is a hallmark of ankylosing spondylitis and psoriatic arthritis. It is not common or consistent with rheumatoid or osteoarthritis.
Like many side effects of arthritis, enthesitis often causes a great deal of comfort. Treating the underlying form of arthritis with biologics can improve the symptoms, which commonly includes inflammation which most often leads to pain and stiffness. Unfortunately traditional DMARDS such as sulfasalazine are not effective against the condition. NSAIDS can be helpful for mild cases. Local injections of cortisone to an infected area can be used to avoid weakening of the surrounding tendons and ligaments, but should be used with caution. Maintaining a healthy weight provides significant benefit as it takes excess pressure off the inflicted area, and typically includes a well-managed diet that controls inflammation. Additionally, heat and cold therapy, resting and elevating the area can offer some relief. As always recommended, discussing any treatment with a physician will optimize pain management and results.