The most common bursa to be inflamed in the foot is the retrocalcaneal bursa (also referred to as the subtendinous calcaneal bursa). Located between the Achilles tendon and the heel bone (calcaneus),
this is a "true" bursa that is present from birth. It acts as a cushion to protect the Achilles tendon from friction against the heel bone. Also commonly affected, the subcutaneous calcaneal bursa
(also referred to as the Achilles bursa), located between the Achilles tendon and the skin, sits a little lower down the ankle towards the heel than the retrocalcaneal bursa. This bursa develops as
you age, an "adventitious" bursa, to protect the tendon from friction at the back of the heel.
Bursitis can be caused by an injury, an infection, or a pre-existing condition in which crystals can form in the bursa. Injury. An injury can irritate the tissue inside the bursa and cause
inflammation. Doctors say that bursitis caused by an injury usually takes time to develop. The joints, tendons, or muscles that are near the bursae may have been overused. Most commonly, injury is
caused by repetitive movements.
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 examine you, including an evaluation of your gait, while you are barefoot, your doctor will ask you to stand still and to walk in order to evaluate how your foot moves as you walk.
An examination of your feet. Your doctor may compare your feet for any differences between them. Then your doctor may examine your painful foot for signs of tenderness, swelling, discoloration,
muscle weakness and decreased range of motion. A neurological examination. The nerves and muscles may be evaluated by checking strength, sensation and reflexes. In addition to examining you, your
health care professional may want to examine your shoes. Signs of excessive wear in certain parts of a shoe can provide valuable clues to problems in the way you walk and poor bone alignment.
Depending on the results of your physical examination, you may need foot X-rays or other diagnostic tests.
Non Surgical Treatment
Many cases of retrocalcaneal bursitis can be resolved with self-care that is focused on reducing inflammation and eliminating activities or positions that aggravate the bursa. Some cases, however,
may become more serious and require more medical interventions. Rarely, surgery is needed. Following the R.I.C.E. formula, or Rest, Ice, Compression, and Elevation, is often sufficient to treat
aseptic bursitis. Rest. People with retrocalcaneal bursitis should avoid activities that irritate the bursa, such as jogging or excessive walking. Ice. Applying a cold compress to the back of the
ankle for about 20 minutes two or three times a day may help alleviate symptoms and decrease swelling. Compression. An elastic medical bandage (e.g. Ace? bandage) wrapped around the affected heel and
ankle can help control swelling. Elevating the affected heel. Sitting down with the leg elevated on a stool or lying down with the foot elevated on a pillow can help reduce blood flow to the area,
thereby reducing inflammation.
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
People can lower the risk of bursitis by gradually strengthening and stretching the muscles around the joints and taking regular breaks from repetitive motion that might irritate bursae. Prolonged
time resting on the elbows or kneeling should be avoided, if it cannot be avoided, wearing cushioned elbow and knee pads can help protect the bursae. Comfortable, supportive, low-heeled shoes can
help prevent bursitis in the foot.