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.
Repetitive, vigorous movement, strenuous and unaccustomed activities that put pressure on a joint, or a blow or other injury can bring on bursitis. The cause can vary depending on where the bursitis
occurs. In the shoulder, for example, it can be brought on by excessive strain, such as from serving in tennis. Kneeling on a hard floor can cause bursitis of the knee, and similarly, repeatedly
resting the elbow on a hard surface (such as a desk) can cause bursitis in that joint. Arthritis, gout, and certain infections can also contribute to the problem. Bursitis, in fact, may signal the
onset of arthritis. While getting older isn't a cause of bursitis, older people, especially older athletes, are more likely to develop the condition.
Where the tendon joins the calcaneal bone, friction can cause the spaces between the tendon, bone and skin to swell and inflame with bursitis. This constitutes a calcaneal bursa. Apart from swelling
over the back of the heel, you?ll feel acute tenderness and pain when you move it or even apply light pressure. Your swollen heel may look more red than the other one, and the swelling is often so
hard it can feel like bone, partly because it sometimes is, as a bony overgrowth can occur in chronic cases.
To begin with, your doctor will gather a medical history about you and your current condition and symptoms. He/she will inquire about the level of your heel pain, the how long you have had the
symptoms and the limitations you are experiencing. Details about what and when the pain started, all are very helpful in providing you with a diagnoses of your ankle / heel.
Non Surgical Treatment
Non-operative treatment is the standard approach to treating posterior heel pain. It is highly desirable to treat this condition non-operatively, as operative treatment is often associated with a
prolonged recovery. Traditional non-operative treatment includes the following. Heel Lift or the Use of a Shoe with a Moderate Heel. Walking barefoot or in a flat-soled shoe increases the tension on
the insertion of the Achilles tendon. Using a heel lift or a shoe with a moderate heel can help reduce the stress on the tendon and decrease the irritation caused by this condition.
Bursectomy is a surgical procedure used to remove an inflamed or infected bursa, which is a fluid-filled sac that reduces friction between tissues of the body. Because retrocalcaneal bursitis can
cause chronic inflammation, pain and discomfort, bursectomy may be used as a treatment for the condition when it is persistent and cannot be relived with other treatments. During this procedure, a
surgeon makes small incisions so that a camera may be inserted into the joint. This camera is called an arthroscope. Another small incision is made so that surgical instruments can be inserted to
remove the inflamed bursa.