A bursa is a closed, fluid-filled sac that functions as a cushion and gliding surface to reduce friction between tissues of the body. The major bursae are located adjacent to the tendons near the
large joints, such as in the shoulders, elbows, hips, and knees. When the bursa becomes inflamed, the condition is known as bursitis. Bursitis is usually a temporary condition. It may restrain
motion, but generally does not cause deformity.
Bursitis is commonly caused by overuse and repeated movements. These can include daily activities such as using tools, gardening, cooking, cleaning, and typing at a keyboard. Long periods of pressure
on an area. For example, carpet layers, roofers, or gardeners who work on their knees all day can develop bursitis over the kneecap. Aging, which can cause the bursa to break down over time. Sudden
injury, such as a blow to the elbow. Bursitis can also be caused by other problems, such as arthritis or infection (septic bursitis).
Some of the symptoms of bursitis in the heel, or retrocalcaneal bursitis, are as described below. Severe pain in the heel area of the foot, sometimes radiating to the ankle, associated with physical
activities like walking, jogging and even on physical contact to the area. The physical signs of heel bursitis, which are noticeable in the heel area, are reddish discoloration of the skin that is
warm to touch.
A thorough subjective and objective examination from a physiotherapist may be all that is necessary to diagnose a retrocalcaneal bursitis. Diagnosis may be confirmed with an ultrasound investigation,
MRI or CT scan.
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. Though rare, particularly challenging cases of retrocalcaneal bursitis might warrant a bursectomy, in which the troublesome bursa is removed from the back of the ankle. Surgery can be
effective, but operating on this boney area can cause complications, such as trouble with skin healing at the incision site. In addition to removing the bursa, a doctor may use the surgery to treat
another condition associated with the retrocalcaneal bursitis. For example, a surgeon may remove a sliver of bone from the back of the heel to alter foot mechanics and reduce future friction. Any
bone spurs located where the Achilles attaches to the heel may also be removed. Regardless of the conservative treatment that is provided, it is important to wait until all pain and swelling around
the back of the heel is gone before resuming activities. This may take several weeks. Once symptoms are gone, a patient may make a gradual return to his or her activity level before their bursitis
symptoms began. Returning to activities that cause friction or stress on the bursa before it is healed will likely cause bursitis symptoms to flare up again.