Retrocalcaneal bursitis involves inflammation of the bursa lying over the heel where the Achilles tendon inserts. The bursa is a small, cushioning sac positioned where the tendon passes over areas of bone around the joints.
The retrocalcaneal bursa can end up inflamed once the Achilles tendon rubs over the bursa and triggers friction against the heel bone. The injury can occur due to trauma from a fall or a sports-related impact. It might also be due to the gradual onset from repeated trauma to the bursa from running and jumping or excessively straining on the heel.
The condition might also be linked with chronic conditions such as:
- Heel spurs
- Plantar fasciitis
- Achilles tendonitis
- Rheumatoid arthritis
What are the indications?
If an individual has retrocalcaneal bursitis, one or several of the following might be present:
- Swelling and discomfort over the rear part of the heel
- Pain when leaning on the heel such as sitting with the heels on the ground
- Intense pain when using the calf muscles such as walking, running or calf raises
Management of retrocalcaneal bursitis
- The daily application of an ice pack is ideal in lowering the pain and swelling.
- Non-steroidal anti-inflammatory drugs (NSAIDs) might be used, but it is best to consult a doctor first.
- A single shot of a corticosteroid with a local anesthetic directly into the bursa might be necessary to stimulate the healing process. An injection is preferably carried out with guidance of an ultrasound.
As the inflammation and pain settles, the aim is to restore the normal range of motion of the ankle as well as muscle strength, endurance and proprioception.
Surgery is not usually required for this injury. Nevertheless, if the condition becomes persistent, removal of the bursa might be considered by the doctor.