If they become injured or irritated, you may feel pain. Tight-fitting shoes that rub the back of the heel can irritate the bursa. Women who wear high-heeled shoes are most at risk for this condition. Athletes who wear ill-fitting shoes may also suffer from it. Pain and swelling in the heel are typical symptoms.
You may also notice redness. Certain shoes, such as tight-fitting ones, may be painful to wear. The aim of treatment is to ease symptoms so that the bursa has time to heal. Treatment choices include:. You may need to alter or limit activities that cause heel pain. These include high-impact activities like running. Over-the-counter medicine.
This helps reduce pain and swelling. This article discusses the symptoms, risk factors, diagnosis, and treatment for retrocalcaneal bursitis. Also discussed are the differences between retrocalcaneal and calcaneal bursitis as well as other possible causes of heel pain. Many of the symptoms and treatments for retrocalcaneal and calcaneal bursitis are the same. Painful bursitis typically occurs when a bursa is repeatedly irritated and becomes inflamed.
In the heel, this irritation is most likely due to:. When inflamed, the normally thin bursa fills with fluid, causing the back of the heel to look swollen.
Bursitis can develop in either the retrocalcaneal bursa and the calcaneal bursa. It is possible for bursitis to develop in both bursae at the same time, making the pain and inflammation more difficult to treat. The purpose of the retrocalcaneal bursa is to reduce friction between the heel bone and the Achilles tendon. Retrocalcaneal bursitis is often associated with other problems in the heel, such as Achilles tendonitis and Haglund deformity. A healthy retrocalcaneal bursa is typically about 1 to 2 cm in diameter and filled with 1 to 1.
The purpose of the calcaneal bursa is to reduce friction between the skin and Achilles tendon. This bursa may go by several names, including calcaneal, subcutaneous calcaneal, superficial calcaneal, or retroachilles bursa. Like the retrocalcaneal bursa, the calcaneal bursa is small but can cause a great deal of pain. Calcaneal bursitis is almost exclusively associated with shoes that dig into the back of the heel.
This condition can cause a hard, red bump to develop at the back of the heel. If treated, inflammation and pain at the back of the heel will usually go away in 2 or 3 weeks. This is known as the superficial or sub-cutaneneous bursa. This can also become inflamed. If it is tender to touch and there is swelling in the bursa on ultrasound, it is known as a subcutaneous bursitis. Similarly this can occur in runners and those over The sub-cutaneneous bursa which is more superficial closer to the skin and normally begins after blunt trauma.
This is a very painful condition and often takes a long time to settle or requires an ultrasound-guided steroid injection to reduce the pain. Obtaining an accurate diagnosis is critical. Clinical assessment cannot accurately diagnose a bursitis.
If you want to know if you have a bursitis then you need to have a diagnostic ultrasound scan carried out. An MRI can also diagnose a bursa but this area is best visualised on ultrasound. At Complete we have a team of highly experienced physiotherapists who are all fully qualified musculoskeletal sonographers. Your assessment will include a full clinical assessment as well as the ultrasound scan.
Ultrasound imaging is an effective assessment tool that is able to assess your bursa as well as ligaments, muscle and bony surfaces. We do not charge for an ultrasound at Complete. It is carried out as part of your assessment to ensure we get the right diagnosis before proceeding with a treatment plan. Bursitis can often be mis-diagnosed or overlooked in the presence of Achilles tendinopathy or tendinitis. It does often co-exist with Achilles tendon issues and is a common reason why Achilles symptoms do not settle down with exercise alone.
It is worth noting that Retrocalcaneal bursitis can also be an early sign of systemic inflammation such as rheumatoid arthritis Suzuki et al, Fever — if the patient spikes a fever the bursitis may have turned into septic bursitis, visit the physician right away if you suspect you have a septic bursitis. Pain or tenderness in the foot or ankle — typically in heel bursitis the pain develops slowly to the point where it becomes unbearable if not treated.
Diagnosis of heel retrocalcaneal bursitis If the pain does not subside in a week, or worsens, schedule an appointment with your orthopedic physician. Treatments for heel retrocalcaneal bursitis Treatment for heel bursitis can range from home therapy and medication for mild cases to steroid injections or surgery for more severe cases. Medical treatment for bursitis includes: Orthotics Splint or brace Physical therapy and rehabilitation Steroid injection Fluid aspiration Bursectomy or surgical removal Recovery from heel retrocalcaneal bursitis Recovery time for patients with heel bursitis can take a few days to many months depending on the severity of the condition.
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