Retrocalcaneal bursitis is the inflammation of the retrocalcaneal bursa, which is located behind the heel bone, also known as the calcaneal bone (hence the name retrocalcaneal). The retrocalcaneal
bursa is a thin, slippery, fluid-filled sac that serves as a both a cushion and lubricant between the heel bone and the Achilles tendon. Inflammation of the retrocalcaneal bursa usually results from
irritation of the bursa. This irritation may be due to certain activities, an underlying health condition such as arthritis, or an abnormality of the foot, such the development of a boney prominence
on the calcaneal bone, called a Haglund's deformity.
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.
You might have Retrocalcaneal Bursitis if you notice any of the following symptoms. You have pain or tenderness at the back of the heel where the Achille's tendon attaches. Have swelling near the
attachment of the tendon to the heel bone. You have noticed a slowly growing bump on the back of the heel. The back of the heel turns red after getting rubbed in shoes. The back of the heel hurts
worse when you run, walk up hill or wear high heels.
Like all other forms of bursitis, initially the physician will take down the history of symptoms experienced by the patient, this will be followed by a detailed physical examination which involves
checking for inflammation signs like pain, redness, and warmth of the heel area. The physician might examine further by moving the ankle a little to determine the exact location of pain. Further
diagnostic tests including x-ray, bone scans, and MRI scan might be suggested if required.
Non Surgical Treatment
Caregivers may give you special shoe inserts with a cutout around the tender area. You may also be told to wear shoes with a reinforced heel counter. This will give better heel control. You may need
other shoe inserts (wedges) to raise your heel so it does not press against the back of the shoe. You may also wear shoes that are open in the back, such as sandals that have no strap across the
heel. You may use ibuprofen (eye-bu-PROH-fen) and acetaminophen (a-seet-a-MIN-oh-fen) medicine for your pain. These may be bought over-the-counter at drug or grocery stores. Do not take ibuprofen if
you are allergic to aspirin. You may be given shots of medicine called steroids (STER-oids) to decrease inflammation. Caregivers may add local anesthesia (an-es-THEE-zah) to the steroids. This
medicine helps decrease bursitis pain. Because these shots decrease swelling and pain, you may feel like your ankle is healed and that you can return to heavy exercise. It is important to not
exercise until your caregiver says it is OK. You could make the bursitis worse if you exercise too soon. You may need surgery to remove the bursa or part of your ankle bone. Surgery is usually not
necessary unless the bursitis is very bad and does not heal with other treatments. Your caregiver may want you to go to physical (FIZ-i-kal) therapy (THER-ah-pee). Physical therapists may use
ultrasound to increase blood flow to the injured area. Caregivers may use massage to stretch the tissue and bring heat to the injury to increase blood flow. These and other treatments may help the
bursitis heal faster. Exercises to stretch your Achilles tendon and make it stronger will be started after the bursitis has healed. You may gradually increase the amount of weight you put on your
foot when caregivers say it is OK. You may be told to stop exercising if you feel any pain.
Surgery is rarely done strictly for treatment of a bursitis. If any underlying cause is the reason, this may be addressed surgically. During surgery for other conditions, a bursa may be seen and