People suffering from heel bursitis may experience pain and tenderness around the affected soft tissue, pain that worsens with movement or pressure, and visible swelling or skin redness in the area
of the inflamed bursa at the back of the heel, which may restrict movement and affect your daily activities. Bursitis is in the heel area is also called Retrocalcaneal Bursitis or Calcaneal Bursitis.
The calf comprises of two major muscle groups, both of which insert into the heel bone via the Achilles Tendons. Between the Achilles tendon and the heel bone lies a bursa known as the retrocalcaneal
bursa. During contraction of the calf, tension is placed through the Achilles tendon and this rubs against the retrocalcaneal bursa. Treatment of Bursitis is similar to the treatment options for
normal heel pain, in particular ice, anti-inflammatories, exercises and orthotics can be beneficial for heel bursitis.
If the posterior-superior portion of the heel has an abnormally large bony prominence protruding from it (called a Haglund's Deformity), in some instances it may rub against the Achilles Tendon. When
this occurs, the bursa between the bone and the tendon will become inflamed, swollen, and painful. This condition is called Retrocalcaneal Bursitis. The presence of a Haglund's Deformity does not
insure that these problems will occur. In order for these problems to occur, the heel and foot must be tilted in such a way as to actually force this bony prominence into the bursa and tendon.
Symptoms of bursitis include pain in the heel, especially with walking, running, or when the area is touched. The skin over the back of the heel may be red and warm, and the pain may be worse with
attempted toe rise (standing on tippy-toes).
Your doctor will check for bursitis by asking questions about your past health and recent activities and by examining the area. If your symptoms are severe or get worse even after treatment, you may
need other tests. Your doctor may drain fluid from the bursa through a needle (aspiration) and test it for infection. Or you may need X-rays, an MRI, or an ultrasound.
Non Surgical Treatment
Rest and apply cold therapy or ice. Ice should not be applied directly to the skin as it may cause ice burns but wrap in a wet tea towel. Commercially available hot and cold packs are often more
convenience than using ice. Taping the bursa with a donut shaped pad to take some of the pressure from footwear may help. A doctor may prescribe anti-inflammatory medication e.g. ibuprofen to reduce
the pain and inflammation. Applying electrotherapy such as ultrasound may reduce inflammation and swelling. A steroid injection followed by 48 hours rest may be given for persistent cases. If the
bursitis is particularly bad and does not respond to conservative treatment then surgery is also an option.
Surgery is rarely done strictly for treatment of a bursitis. If any underlying cause is the reason, this may be addressed surgically. During surgery for other conditions, a bursa may be seen and