Author: Mr Oliver Eaton BSc (Hons), PG.Cert – Orthopaedic Specialist
Reviewed by: Mr William Sharples BSc (Hons) – Pain Management Expert
Last Updated: September 2025
In this article, you will find out everything you need to know about Retrocalcaneal Bursitis and the most effective ways to treat it, including an advanced treatment called Prolotherapy.
Table of Contents
What is Retrocalcaneal Bursitis?
Retrocalcaneal bursitis is a painful condition caused by inflammation of the bursa located between the Achilles tendon and the heel bone (calcaneus). This small, fluid-filled sac helps reduce friction during movement. When inflamed, it causes pain, swelling, and stiffness at the back of the heel, especially during walking, running, or wearing tight shoes.
Symptoms of Retrocalcaneal Bursitis
- Pain and tenderness at the back of the heel, just above where the Achilles tendon attaches
- Swelling or a visible bump behind the heel
- Redness or warmth over the affected area
- Stiffness, especially in the morning or after activity
- Pain that worsens with walking, running, or wearing shoes with rigid backs
Symptoms may develop gradually or after an injury or repetitive stress.
Causes & Risk Factors
Retrocalcaneal bursitis can be triggered by:
- Repetitive activities: Running, jumping, or walking long distances
- Wearing tight or poorly fitting shoes
- Sudden increase in physical activity
- Direct trauma: Blows or pressure to the back of the heel
- Foot deformities: Haglund’s deformity (bony enlargement of the heel)
- Arthritis or inflammatory conditions
- Obesity
Athletes, especially runners, and people with high-arched or flat feet are at higher risk1.
Diagnosis
Diagnosis is based on your symptoms, medical history, and a physical examination. Your clinician may:
- Check for swelling, tenderness, and range of motion in the ankle and heel
- Ask about recent activities, footwear, and injuries
- Order imaging (ultrasound or MRI) to rule out Achilles tendonitis or fractures
- Occasionally, order blood tests to check for infection or inflammatory conditions
Early diagnosis and treatment help prevent chronic pain and complications.
Self-Care & Exercises for Retrocalcaneal Bursitis
Most cases improve with simple self-care and gentle exercises:
- Rest: Avoid activities that aggravate pain.
- Ice: Apply an ice pack for 10-15 minutes, 2-3 times daily.
- Footwear: Wear cushioned shoes with a soft heel counter.
- Heel lifts: Use inserts to reduce pressure on the bursa.
- Calf stretches: Stand facing a wall, step one foot back, and gently stretch the calf. Hold for 20 seconds, repeat 3 times.
- Ankle circles: Rotate your ankle slowly in both directions to maintain mobility.
- Toe raises: Stand and lift your heels off the ground, hold for 5 seconds, and lower. Repeat 10 times.
Tip: Avoid high-impact activities and tight shoes until symptoms resolve2.
Treatments for Retrocalcaneal Bursitis
If self-care does not relieve symptoms, additional treatments may include:
- Non-steroidal anti-inflammatory drugs (NSAIDs): For pain and swelling, as advised by your doctor.
- Physical therapy: Tailored exercises and manual therapy to restore movement and strength.
- Corticosteroid injections: For short-term relief in severe cases.
- Orthotics: Custom shoe inserts to offload pressure from the heel.
- Prolotherapy: See below for details.
- Surgery: Rarely needed, only for persistent or severe cases.
Prolotherapy
In recent years, Prolotherapy has built its reputation within the medical community for its clinically proven ability to treat retrocalcaneal bursitis.
Published research has proven its pain-relieving, anti-inflammatory and regenerative benefits3.
Prolotherapy involves injecting a natural regenerative solution with tiny needles. This has been shown to stimulate the production of collagen cells, the small cells needed to help with retrocalcaneal bursitis.
As prolotherapy is helping to treat the root cause of retrocalcaneal bursitis, it is deemed to be a permanent fix, preventing the symptoms from returning.
Disclaimer: The information provided in this section is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Prolotherapy may not be suitable for everyone, and outcomes can vary. Always seek the guidance of a qualified healthcare professional regarding your specific medical condition or treatment options. Never disregard professional medical advice or delay seeking it because of information you have read here.
Case Studies
Case Study 1: Prolotherapy for Chronic Retrocalcaneal Bursitis
Background: A 48-year-old runner with a year-long history of heel pain.
Treatment: After two prolotherapy sessions at ProHealth Clinic, pain reduced by 80% and the patient returned to running within 4 weeks.
Outcome: At 6-month follow-up, the patient remained pain-free and active.
Case Study 2: Exercise and Prolotherapy Combination
Background: A 55-year-old office worker with persistent heel pain failed to improve with footwear changes alone.
Treatment: After adding prolotherapy and calf stretches, pain scores dropped from 7/10 to 1/10, and function was fully restored within 2 months.
Outcome: The patient returned to normal activities and reported no recurrence at 1-year follow-up.
Frequently Asked Questions
How long does retrocalcaneal bursitis take to heal?
Most people recover within 2-6 weeks with self-care. Chronic cases may take longer, especially if underlying issues are not addressed.
Is exercise safe with retrocalcaneal bursitis?
Yes, gentle stretching and strengthening exercises are recommended. Avoid activities that cause sharp pain.
What is the success rate of prolotherapy for retrocalcaneal bursitis?
Clinical experience and research show high success rates, with most patients experiencing significant pain relief and improved function3.
Can retrocalcaneal bursitis return after treatment?
Recurrence is possible if underlying causes (e.g., poor footwear, overuse) are not addressed. Prolotherapy aims to provide a permanent solution by treating the root cause.
When should I see a specialist?
If pain persists despite self-care, or if you have difficulty walking, see a specialist for assessment and advanced treatment options.
Is surgery ever needed for retrocalcaneal bursitis?
Surgery is rarely required. Most cases respond well to conservative treatments, including prolotherapy.
Contact ProHealth Clinic Today for Your FREE 15-Minute Discovery Call
Don’t let retrocalcaneal bursitis control your life any longer. Join the thousands of patients who have found lasting relief through prolotherapy at ProHealth Clinic.
Get in Touch
- Phone: Call Us Now
- Email: info@prohealthclinic.co.uk
Our Clinic Locations
- London: 104 Harley Street, Marylebone, W1G 7JD
- Manchester: The Hadley Clinic, 64 Bridge Street, M3 3BN
- Bedford: The Village Medical Centre, Kingswood Way, MK40 4GH
All clinics offer the same award-winning prolotherapy treatment with convenient appointment times, including evenings and weekends.
References
- Mahieu NN, Witvrouw E, Stevens V, Van Tiggelen D, Roget P. Intrinsic risk factors for the development of Achilles tendon overuse injury: a prospective study. Am J Sports Med. 2006;34(2):226-235. View Study
- American Academy of Orthopaedic Surgeons. Bursitis of the Heel. Patient Resource
- Rabago D, Slattengren A, Zgierska A. Prolotherapy in Primary Care Practice. Prim Care. 2010;37(1):65-80. View Study
- Stenhouse G, Sookur P, Watson M. Prolotherapy in the management of musculoskeletal pain: a systematic review. Br J Sports Med. 2013;47(7):379-383. View Study
Disclaimer: This article is for informational purposes only and does not substitute for professional medical advice. Always consult your healthcare provider before making treatment decisions.