What is heel (retrocalcaneal) bursitis?

Heel bursitis, also known as retrocalcaneal bursitis, is a type of bursitis (a condition where small fluid filled sacs that act as a cushion around joints become inflamed and swollen) that causes pain above the heal on the foot.

When the bursa become inflamed and irritated, your body’s ability to absorb the shock from normal activity on your feet decreases.

Causes of heel (retrocalcaneal) bursitis

Causes of heel bursitis include:

  • Tight calf muscles
  • Arthritis
  • Abnormality of the foot
  • Activities such as running or walking
  • Sports injuries

Risk factors for heel (retrocalcaneal) bursitis

Risk factors for heel bursitis include:

  • Age — as people get older the bursa’s shock absorption lessons.
  • Preexisting conditions — preexisting conditions such as osteoarthritis, rheumatoid arthritis, gout and pseudogout can be a risk factor for heel bursitis.
  • Footwear — wearing footwear that does not fit properly and digs into the heel.
  • Long distance running — long distance runners or walkers are at a higher risk to develop heel bursitis.

Symptoms of heel (retrocalcaneal) bursitis

Symptoms of heel bursitis include:

  • Swelling in the foot or ankle near the top of the heel bone.
  • Fever — if the patient spikes a fever the bursitis may have turned into septic bursitis, visit the physician right away if you suspect you have a septic bursitis.
  • Pain or tenderness in the foot or ankle — typically in heel bursitis the pain develops slowly to the point where it becomes unbearable if not treated.

Diagnosis of heel (retrocalcaneal) bursitis

If the pain does not subside in a week, or worsens, schedule an appointment with your orthopedic physician.

An orthopedic physician or primary care doctor will perform a full medical exam and may order an x-ray, MRI or ultrasound if they suspect the patient has heel bursitis. Images from these modalities will determine whether the patient has heel bone deformities or bone spurs where the Achilles attaches.

Treatments for heel (retrocalcaneal) bursitis

Treatment for heel bursitis can range from home therapy and medication for mild cases to steroid injections or surgery for more severe cases.

Medical treatment for bursitis includes:

  • Orthotics
  • Splint or brace
  • Physical therapy and rehabilitation
  • Steroid injection
  • Fluid aspiration
  • Bursectomy or surgical removal

Recovery from heel (retrocalcaneal) bursitis

Recovery time for patients with heel bursitis can take a few days to many months depending on the severity of the condition.

Patients who are recovering from heel bursitis should pay careful attention to the shoes they are wearing to ensure they fit properly and are not causing additional pressure of the heel.

Patients should also work closely with their orthopedic physician to determine when they can return to normal activities.

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