In this article you will find out everything you need to know about heel bursitis and the most effective ways to treat the condition.
Bursa is a fluid-filled sac in our body. Bursa is present in almost every complex joint in our body. The basic purpose behind these fluid-filled sacs is to reduce friction and provide lubrication. The reduction in friction and lubrication thus helps in the stability and protection of joints.
Any deformation produced in this bursa can cause disturbance and inflammation of the bursa and pain called calcaneal bursitis. Inflammation in the bursa is called bursitis. Here in this blog we are gonna discuss Heel bursitis. Heel bursitis is an inflammation in the bursa of the heel. It causes heel pain. Very often adults face this situation and it causes discomfort and disability. (1) Also this condition is misunderstood many times. So here we are gonna tell you a complete guide about Heel bursitis.
What is heel bursitis
First of all, let us start with a basic understanding of heel bursitis. If anyone has seen an X-ray you see an irregular bone calcaneus. That bone is called heel bone. Here in this bone, our calf muscles get inserted through a tendon called the Achilles tendon. The Achilles tendon is the strongest tendon of our body. In children, retrocalcaneal bursitis is a distinct condition causing heel pain. (2)
There are two bursae located in our heel region. The one is the retrocalcaneal bursa on the calcaneus and the other one is the retro Achilles bursa on top of the Achilles tendon. The retrocalcaneal bursa is located where the Achilles tendon inserts into the calcaneus. Inflammation of a retrocalcaneal bursa is called heel bursitis. It causes severe discomfort and heel pain. Many people confused this bursitis with Achilles tendinitis which is inflammation of the Achilles tendon.
What are the symptoms of Heel bursitis
The most common foot disease is Heel pain We associate a variety of names with Heel pain that including the policemen’s heel, tennis heel, joggers heel etc. (3) The pain in the heel region is one of the major symptoms of heel bursitis. You can feel pain and swell in the back of the knee. when you stand on your toes you feel pain. The heel and surrounding area feel warm to the touch.
Your skin colour around the heel starts to change skin the skin around the heel becomes reddish. The main movement that gets affected is dorsiflexion. The condition of pain gets worse when you dorsiflex your foot. The affected person’s ankle joint gets stiffened and the person feels difficulty walking.
Causes of Heel bursitis
Now let us discuss the common causes of bursitis of the heel. The overuse of calf muscles and excessive stretching of the Achilles tendon cause heel bursitis. Any foot or ankle deformity can lead to heel bursitis. Different causes of heel pain are Haglund’s deformity and Achilles tendon bursitis.
Sometimes some inflammatory infections can lead to Heel bursitis. Rheumatoid Arthritis can also cause this bursitis and pain at the back of the heel. Ill-fitting shoes exert pressure on your foot and at back and can become a reason for heel bursitis. So need to be conscious of these reasons. Sometimes bursaries are linked to Achilles tendinitis which is inflammation of the Achilles tendon, spurs in the heel related to heel pain, and plantar fasciitis. A calcaneal spur or bone spur is a bony prominence that can cause heel bursitis.
Diagnosis of Heel bursitis
The next question comes about how you diagnose heel bursitis. The answer simply lies in the fact that when you feel pain in the region where the Achilles tendon gets inserted. And if the pain increases day by day you should consult a doctor. Only a doctor can diagnose it properly.
Doctors just need to eliminate all other possibilities that could cause heel pain like fracture, Achilles tendinopathy etc. In this regard, the doctor could ask the patient for an X-ray, MRI or any other test. Doctors can get help from patients also. If there was some inflammation history or any tendon rupture.
Calcaneal bursitis Treatment at Home
In the initial stages, heel bursitis can be treated with some home remedies. It can also be treated with physical therapy. In physical therapy, the main concern is to stretch Athe Achilles tendon. You can buy heel cups and comfortable shoes to make your back of the ankle in a relaxed state. Physio needs to be done regularly.
Another is to apply ice to the inflamed area twice a day for 10-15 days and take complete rest. It will benefit you. For the future, we recommend exercise and maintaining flexible calf muscles. The stronger the calf muscles the lesser chance of bursa getting affected by bursitis. By doing all this if the pain doesn’t go away you should consult your doctor.
Bursitis treatment by medicine
If the pain gets worse then Image guide corticosteroid injection or steroid injection causes a decrease in pain in the majority of patients. (4) Get a steroidal injection in the bursa but after getting an injection prevent stretching your ligaments, the Achilles tendon it will help you heal up. If one wants to take medicine then nonsteroidal anti-inflammatory drugs should be taken. Ibuprofen and acetaminophen are recommended for pain relief.
Very rarely does surgery needs to be done to remove the bursa. A proper surgical approach for patients with retrocalcaneal bursitis(Haglund’s Syndrome) has not been defined. (5)
Confusion and inconsistency in the terminology of Achilles tendon pathology have increased throughout the years. (6)
Frequently Asked Questions
How do you treat bursitis in the heel?
Bursitis if not chronic can be easily treated with home remedies like applying ice, and taking complete rest. But in the majority of the cases, anti-inflammatory and non-steroidal (nsaids) are to be taken in the bursitis treatment plan. Sometimes surgery is a must option. Surgery involves bursectomy which is the removal of the inflamed bursa.
In the early stages, bursitis treatment can be done with some healthy tips. Taking complete rest for 15-20 days can help you. Also, use flat shoes. Specifically, women don’t use high heels. Also applying ice is an effective method also twice a day. These all are conservative treatments. Bursitis is merely overuse of the Achilles tendon and overstretching so taking rest will surely help you in bursal treatment.
Does heel bursitis go away?
Chronic bursitis can go away automatically after some days or a week. But if the bursa gets thickened condition can become worse. If bursitis comes back it can cause acute bursitis.
But if the pain gets worse then you should not ignore it and consult a Healthcare professional specifically a podiatrist immediately to avoid any side effects. Otherwise, you are gonna harm yourself badly. You should use flat shoes in which arch support, an important factor of the musculoskeletal system, is more.
Does walking make heel bursitis worse?
Yes as walking involve stretching the heel and Achilles tendon so bursitis becomes worse by stretching. So you should avoid walking and take the complete test for 15-20 days.
Walking involves stretching your tendon by calf muscles that insert into the back of the calcaneus through the Achilles tendon. That’s you should avoid walking for some time. If you want to walk then use running shoes and orthotics. This shoe inserts its sole on the floor such that no harm occurred
What does Achilles bursitis feel like?
Redness, discomfort, and warmth at the back of the heel are early signs of posterior Achilles tendon bursitis. The top layer of skin may eventually wear away.
A bursa forms and becomes inflamed after several months, looking like a swollen, red or flesh-coloured region (nodule) that is painful and squish. All these are visible scenes of Achilles bursitis. If you note any of them you should consult your doctor.
Should you massage heel bursitis?
Massage on the bursa is not recommended but massage on areas around the bursa and calf muscles and leg can be proved to be beneficial. It will heal your soft tissue and subcutaneous ligaments. The reason is that massage causes an increase in blood circulation and speeds up the healing process.
Our blood involves a natural healing process and cells attack germs at the site of infection so an increase in blood circulation means an increase in the healing process.
What causes bursitis in the heel?
Heel bursitis is sometimes caused by inflammatory infections.
This bursitis and pain in the back of the heel can also be caused by rheumatoid arthritis.
Improperly fitting shoe puta strain on your foot and back, which can lead to heel bursitis.
As a result, several factors must be considered.
Bursaries are sometimes associated with Achilles tendinitis (inflammation of the Achilles tendon), heel spurs (heel pain), and plantar fasciitis.
- Aldridge T. Diagnosing Heel Pain in Adults [Internet]. Aafp.org. 2022 [cited 19 May 2022]. Available from: https://www.aafp.org/afp/2004/0715/p332.html
- Heneghan M, Wallace T. Heel pain due to retrocalcaneal bursitis-radiographic diagnosis (with a historical footnote on Sever’s disease). 2022.
- Agyekum E, Ma K. Heel pain: A systematic review. Chinese Journal of Traumatology. 2015;18(3):164-169.
- Boone S, Uzor R, Walter E, Elsinger E, Catanese D, Ye K et al. Safety and efficacy of image-guided retrocalcaneal bursa corticosteroid injection for the treatment of retrocalcaneal bursitis. 2022.
- Anderson J, Suero E, O’Loughlin P, Kennedy J. Surgery for Retrocalcaneal Bursitis: A Tendon-splitting versus a Lateral Approach. 2022.
- van Dijk C, van Sterkenburg M, Wiegerinck J, Karlsson J, Maffulli N. Terminology for Achilles tendon related disorders. 2022.