Bursae are fluid-filled sacs that act as shock absorbers and cushions for our bones and tendons. There are two such sacs located on the back of your heel. The subtendinous calcaneal, also called
retrocalcaneal bursa, is situated between the Achilles tendon and the heel bone (calcaneus). The subcutaneous calcaneal bursa, which is also referred to as the Achilles bursa, is found on the
backside of the heel and Achilles. If either or both of these bursae become inflamed, the result is pain and tenderness.
Bursitis occurs when the bursae become irritated or infected, often causing pain on movement. When infection is involved, medical intervention is necessary to fight the underlying infection and
prevent it from spreading, when infection is not involved, prompt medical attention can prevent the condition from becoming worse over time.
Pain and tenderness are common symptoms. If the affected joint is close to the skin, as with the shoulder, knee, elbow, or Achilles tendon, swelling and redness are seen and the area may feel warm to
the touch. The bursae around the hip joint are deeper, and swelling is not obvious. Movement may be limited and is painful. In the shoulder, it may be difficult to raise the arm out from the side of
the body. Putting on a jacket or combing the hair becomes a troublesome activity. In acute bursitis symptoms appear suddenly, with chronic bursitis, pain, tenderness, and limited movement reappear
after exercise or strain.
Carrying out a diagnosis for bursitis is fairly straightforward. The doctor will examine the affected area and ask the patient some questions about his/her recent activities. If the patient has a
high temperature the physician may take a small sample of fluid from a bursa near the affected body part. The sample will be tested for bacteria, and perhaps also crystals. If the patient does not
get better after treatment the doctor may carry out further tests so that he/she can eliminate the possibility that the symptoms might not be due to something else. These may include an x-ray, to
make sure no bones are broken or fractured. Blood tests, to check for rheumatoid arthritis. A CT scan or MRI scan to see if there is a torn tendon.
Non Surgical Treatment
Physiotherapy treatment is vital to hasten the healing process, ensure an optimal outcome and reduce the likelihood of injury recurrence in all patients with retrocalcaneal bursitis. Treatment may
comprise soft tissue massage (particularly to the calf muscles), joint mobilization (of the ankle, subtalar joint and foot), dry needling, electrotherapy (e.g. ultrasound), stretches, the use of heel
wedges, the use of crutches, ice or heat treatment, arch support taping, the use of a compression bandage, exercises to improve strength, flexibility, balance and core stability, education,
anti-inflammatory advice, activity modification advice, biomechanical correction (e.g. the use of orthotics), footwear advice, a gradual return to activity program.
Contact your physician if bursitis pain is disabling (when movement of the joint is largely or entirely restricted), if the pain doesn?t subside after a week of self-care, or if the joint is red and
swollen. Also call your doctor if you develop a fever, which could signal infectious bursitis-a condition that especially can afflict the elbow. Except for the fever, symptoms resemble other forms of
bursitis, but infectious bursitis requires immediate medical attention.