Retrocalcaneal bursitis is the painful inflammation and swelling of the retrocalcaneal bursa that is situated between the calcaneus (heel bone) and the Achilles tendon. A bursa is a small fluid
filled sac that forms around joints in areas where there is a lot of friction between muscles, tendons and outcrops of bone. The bursae position themselves in between the tendon or muscle and the
bone, buffering any friction from movement. To picture a bursa imagine it as a very small water filled balloon that sits in places where things rub against each other, such as in between a tendon and
a bone, to provide a soft smooth cushion for the tendon to pass over painlessly. The covering of the bursa also acts as a lubricant and aids the tendon?s movement. It is estimated that there is over
150 bursae in your body which protect the joint and tendons from wear. They are all very small and unnoticeable until they become swollen and painful with bursitis.
Bursitis, tendinitis, and other soft tissue rheumatic syndromes typically result from one or more factors. These include: Play or work activities that cause overuse or injury to the joint areas
Incorrect posture Stress on the soft tissues from an abnormal or poorly positioned joint or bone (such as leg length differences or arthritis in a joint) Other diseases or conditions (rheumatoid
arthritis, gout, psoriasis, thyroid disease, or an unusual drug reaction) Infection.
Pain in the heel, especially with walking, running, or when the area is touched. Pain may get worse when rising on the toes (standing on tiptoes). Red, warm skin over the back of the heel.
Diagnosis of heel bursitis can be made by your health practitioner and is based on the following. Assessing the location of the pain by palpating the back of the heel. Assessment of any inflammation
at the back of the heel. Assessment of biomechanics and foot function. Ultrasound or MRI can reveal inflammation of the retro calcaneal bursa.
Non Surgical Treatment
If you follow these steps, most attacks of bursitis should subside in four or five days and all symptoms should be gone within two weeks. Rest the body part that hurts. If you suspect that one
activity has caused the pain, stop it until the pain is entirely gone. A sling, splint, or padding may be needed to protect the area from possible bumps or irritation. Try over-the-counter pain
relievers. Nonprescription NSAIDs (aspirin, ibuprofen, and naproxen) will help reduce pain and swelling, though they won?t accelerate healing. Acetaminophen will help with pain but it doesn?t reduce
inflammation. Ice it, then heat it. Apply ice packs during the first two days to bring down swelling. Then use heat-warm baths or a heating pad (on a medium or low setting)-to ease pain and stimulate
blood flow. Don?t push it. Resume exercising only after you feel better. Start with gentle activity. Skip the liniments. Liniments and balms are no help for bursitis. Liniments don?t penetrate deeply
enough to treat bursitis, they mainly warm the skin and make it tingle, thus distracting attention from the pain beneath. Massage is likely to make matters worse. Undergo physical therapy. Physical
therapy strengthens joint muscles that have been affected by bursitis and may help prevent the bursitis from getting worse.
Because many soft tissue conditions are caused by overuse, the best treatment is prevention. It is important to avoid or modify the activities that cause problems. Underlying conditions such as leg
length differences, improper position or poor technique in sports or work must be corrected. Be aware of potential overuse or injury in your daily activities and change your lifestyle to prevent
problems. Otherwise, problems may persist or occur repeatedly. Following are some ways you can avoid future problems. Wear walking or jogging shoes that provide good support. High-top shoes provide
support for people with ankle problems. Wear comfortable shoes that fit properly. Wear heel cups or other shoe inserts as recommended by your doctor. Exercise on level, graded surfaces.