Bursitis is an inflammation of a bursa. The heel has three areas that are involved in bursitis. Retrocalcaneal Bursa which is located between the Achilles tendon and heel bone. Subcutaneous calcaneal
bursa which is located between the skin and where the Achilles tendon attaches to the heel bone. Plantar-calcaneal bursitis is located between the heel bone and the plantar fascia (thick fibrous
tissue that inserts into the heel bone).
Systemic diseases such as rheumatoid arthritis, ankylosing spondylitis, reactive arthritis, psoriatic arthritis, scleroderma, systemic lupus erythematosus, pancreatitis, Whipple disease, oxalosis,
uremia, hypertrophic pulmonary osteoarthropathy, and idiopathic hypereosinophilic syndrome have also been associated with bursitis.
Posterior heel pain is the chief complaint in individuals with calcaneal bursitis. Patients may report limping caused by the posterior heel pain. Some individuals may also report an obvious swelling
(eg, a pump bump, a term that presumably comes from the swelling's association with high-heeled shoes or pumps). The condition may be unilateral or bilateral. Symptoms are often worse when the
patient first begins an activity after rest.
Careful examination by your physician or physiotherapist can determine if the inflammation is from the Achilles tendon or from the retrocalcaneal bursa. Tenderness due to insertional Achilles
tendinitis is normally located slightly more distal where the tendon inserts into the back of the heel, whereas tenderness caused by the retrocalcaneal bursa is normally palpable at the sides of the
distal Achilles tendon. Diagnosis can be confirmed with an ultrasound investigation, MRI or CT scan.
Non Surgical Treatment
It is important to treat bursitis in the early stages to reduce the symptoms, minimize damage and maintain motion and strength in your foot. Resting your ankle, using proper cushioning, wearing
comfortable footwear and reducing any activities that add pressure on your bursa will help to reduce your pain and bursitis inflammation.
Surgery is rarely need to treat most of these conditions. A patient with a soft tissue rheumatic syndrome may need surgery, however, if problems persist and other treatment methods do not help