Retrocalcaneal bursitis is a condition characterized by tissue damage and inflammation of the retrocalcaneal bursa (a small fluid filled sac located at the back of the heel) causing pain in the heel
region. A bursa is a thin fluid filled sac found in various places throughout the body. Bursae are designed to reduce friction between adjacent layers of tissue and are filled with lubricating fluid.
They are typically located in regions of the body where tissue layers may rub against each other or against bony prominences The muscle group at the back of the lower leg is commonly called the calf.
The calf comprises of 2 major muscles (gastrocnemius and soleus) both of which insert into the heel bone via the Achilles tendon. Between the Achilles tendon and the heel bone lies a bursa known as
the retrocalcaneal bursa.
The most common cause for bursitis in the heel is overuse. If you repeatedly use your ankle, the bursa becomes irritated, causing swelling and inflammation. This is usually seen in individuals who do
too much walking or running. The risk for developing this condition worsens if you suddenly start an intensive workout routine without conditioning your body to become used to the intensity.
The main symptom of heel bursitis is pain. You may experience pain in your heel when you walk or run. There may also be pain if the area is touched or if you stand on your tiptoes. In addition to
pain, the area may appear red and warm, which are both signs of inflammation. Even if you have these symptoms, only a doctor can determine if you have bursitis of the heel. Your doctor will use these
symptoms along with a general exam to determine if you are suffering from bursitis of the heel.
Diagnosis is first by clinical suspicion of symptoms. This can be mistaken for gout or infection especially in the big toe region. A diagnosis of bursitis is usually used in combination of the
underlying cause, for instance a bunion deformity, Haglund's deformity, or Heel Spur Syndrome. Many times the cause needs to be addressed to rid the problem of bursitis.
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.
Prevention can be accomplished by controlling your foot structure with good supportive shoes or arch supports. Pay attention to early signs of friction like blister formation. This tells you where
the areas that are more likely to cause a bursa to form and subsequently a bursitis.