Skip to main content

Health Encyclopedia

Search the Health Encyclopedia

Bursitis of the heel

Definition

Bursitis of the heel is swelling of the fluid-filled sac (bursa) at the back of the heel bone.

Alternative Names

Insertional heel pain; Retrocalcaneal bursitis

Causes

A bursa acts as a cushion and lubricant between tendons or muscles sliding over bone. There are bursas around most large joints in the body, including the ankle.

The retrocalcaneal bursa is located in the back of the ankle by the heel. It is where the large Achilles tendon connects the calf muscles to the heel bone.

Repeated or too much use of the ankle can cause this bursa to become irritated and inflamed. It may be caused by too much walking, running, or jumping.

This condition is very often linked to Achilles tendinitis. Sometimes retrocalcaneal bursitis may be mistaken for Achilles tendinitis.

Risks for this condition include:

  • Starting a very intense workout schedule
  • Suddenly increasing activity level without the right conditioning
  • Changes in activity level¬†
  • History of arthritis that is caused by inflammation

Symptoms

Symptoms include:

  • 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

Exams and Tests

Your health care provider will take a history to find out if you have symptoms of retrocalcaneal bursitis. An exam will be done to find the location of the pain. The provider will also look for tenderness and redness in the back of the heel.

The pain may be worse when your ankle is bent upward (dorsiflex). Or, the pain may be worse when you rise on your toes.

Most of the time, you will not need imaging studies such as x-ray and MRI at first. You may need these tests later if the first treatments DO NOT lead to improvement. Inflammation may show on a MRI.

Treatment

Your provider may recommend that you do the following:

  • Avoid activities that cause pain.
  • Put ice on the heel several times a day.
  • Take nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen.
  • Try using over-the-counter or custom heel wedges in your shoe to help decrease stress on the heel.
  • Try ultrasound treatment during physical therapy to reduce inflammation.

Have physical therapy to improve flexibility and strength around the ankle. The focus will be on stretching your Achilles tendon. This can help the bursitis improve and prevent it from coming back.

If these treatments DO NOT work, your provider may inject a small amount of steroid medicine into the bursa. After the injection, you should avoid overstretching the tendon because it can break open (rupture).

If the condition is connected to Achilles tendinitis, you may need to wear a cast on the ankle for several weeks. Very rarely, surgery may be needed to remove the inflamed bursa.

Outlook (Prognosis)

This condition most often gets better in several weeks with the proper treatment.

When to Contact a Medical Professional

Call your provider if you have heel pain or symptoms of retrocalcaneal bursitis that DO NOT improve with rest.

Prevention

Things you can do to prevent the problem include:

  • Use proper form when exercising.
  • Maintain as good flexibility and strength around the ankle to help prevent this condition.
  • Stretch the Achilles tendon to help prevent injury.
  • Wear shoes with enough arch support to decrease the amount of stress on the tendon and inflammation in the bursa.

References

Joseph RL, Hudgins TH. Foot and ankle bursitis. In: Frontera WR, Silver JK, Rizzo TD, eds. Essentials of Physical Medicine and Rehabilitation. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 86.

Kadakia AR. Heel pain and plantar fasciitis: hindfoot conditions. In: Miller MD, Thompson SR, eds. DeLee and Drez's Orthopaedic Sports Medicine. 4th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 119.

Review Date:9/22/2016
Reviewed By:C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997-A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

adam.com

The Agency for Health Care Administration (Agency) and this website do not claim the information on, or referred to by, this site is error free. This site may include links to websites of other government agencies or private groups. Our Agency and this website do not control such sites and are not responsible for their content. Reference to or links to any other group, product, service, or information does not mean our Agency or this website approves of that group, product, service, or information.

Additionally, while health information provided through this website may be a valuable resource for the public, it is not designed to offer medical advice. Talk with your doctor about medical care questions you may have.

Health
Outcome Data

No data available for this condition/procedure.

Health Encyclopedia

More Features

We Appreciate Your Feedback!
1. Did you find this information useful?
         Yes
         No
2. Would you recommend this website to family and friends?
         Yes
         No