There are over 150 bursae in the human body. Usually bursae are present from birth, but they may form in response to repeated pressure. Each sac contains a small amount of synovial fluid, a clear
liquid that acts as a lubricant. Inflammation causes pain on movement. The most common site for bursitis to occur is the shoulder (subdeltoid), but it also is seen in the elbows (olecranon), hips
(trochanteric), knees, heels (Achilles), and toes. The affected area may be referred to as "frozen," because movement is so limited. In the knee there are four bursae, and all can become inflamed
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.
When the bursa becomes inflamed after an injury, symptoms usually develop suddenly. When the bursa develops without an injury, symptoms may develop gradually. With both posterior and anterior
Achilles tendon bursitis, symptoms usually include swelling and warmth at the back of the heel. A minimally red, swollen, tender spot develops on the back of the heel. When the inflamed bursa
enlarges, it appears as a red lump under the skin of the heel and causes pain at and above the heel. If posterior Achilles tendon bursitis becomes chronic, the swelling may become hard, fluid-filled,
and red or flesh-colored.
When you suspect you have retrocalcaneal bursitis, your foot doctor will begin by taking a complete history of the condition. A physical exam will also be performed. X-rays are usually taken on the
first visit as well to determine the shape of the heel bone, joint alignment in the rearfoot, and to look for calcium deposits in the Achilles tendon. The history, exam and x-rays may sufficient for
your foot surgeon to get an idea of the treatment that will be required. In some cases, it may be necessary to get an ultrasound or MRI to further evaluate the Achilles tendon or its associated
bursa. While calcium deposits can show up on xray, the inflammation in the tendon and bursa will show up much better on ultrasound and MRI. The results of these tests can usually be explained on the
first visit. You can then have a full understanding of how the problem started, what you can do to treat prevent it from getting worse/ You will also know which treatment will be most helpful in
making your heel pain go away.
Non Surgical Treatment
One of the most effective treatments for infracalcaneal bursitis is to temporarily avoid weight-bearing activities that put stress or strain on your heel bone. PRICE (protection, rest, hot/cold
contrast compresses, compression, and elevation) is another good acute management technique for this foot problem. Changing your footwear is an effective long-term prevention and treatment tool for
infracalcaneal bursitis. Footwear that possess a flat support base, a sufficiently wide toe box to accommodate natural toe splay, and a flexible sole are best for preventing and managing
infracalcaneal bursitis. An integrated approach to this problem usually involves the use of padded socks that help reduce pressure, friction, and inflammation in your affected area. Natural
anti-inflammatory agents can also be helpful in quelling inflammation, reducing pain, and improving treatment times for infracalcaneal bursitis. In rare cases, more aggressive treatment methods may
be required, such as cortisone injections or surgery to drain the bursal sac.
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.