Bursae are small, fluid-filled sacs that protect tendons and bones. Heel bursitis is the inflammation of the bursae that cushion the back of the heel. Often resolving on its own, heel bursitis, also known as retrocalcaneal bursitis, may require treatment to manage pain.
Symptoms of Heel Bursitis
– Acute Bursitis: Pain in the bursae, worsening with some movements, and swelling.
– Chronic Bursitis: Significant swelling and thickening of the bursae, warm bursae, and inflamed skin near the affected bursae.
Causes of Heel Bursitis
– Prolonged pressure on the bursae.
– Repetitive motion.
– Trauma.
– Rheumatoid arthritis, osteoarthritis, gout.
– Autoimmune conditions like systemic lupus erythematosus and scleroderma.
– Unknown causes.
Risk Factors
– Older adults, individuals with obesity.
– Manual laborers like gardeners, mechanics, and plumbers.
– Septic bursitis risk increases in those with compromised immune systems (e.g., diabetes, alcohol use disorder, HIV, arthritis).
Diagnosis
Diagnosis is based on symptoms, supplemented by:
– Imaging tests for trauma.
– Aspiration and testing of bursae fluid for septic bursitis and diseases like gout.
Treatment
– Rest, ice or cold compresses, elevation of the heel.
– Footwear reducing heel pressure.
– Pain medications (acetaminophen, NSAIDs).
– Corticosteroid injections (63% effectiveness in short-term pain reduction).
– Surgery showing long-term improvements.
Exercises and Prevention
– Physical therapy exercises to strengthen muscles around the bursae.
– Maintaining a healthy BMI, wearing proper footwear, avoiding trauma and repetitive motions to the heel.
Outlook
Generally positive, with potential recurrence. Septic bursitis can lead to complications like ruptured bursae, wound-healing issues, and osteomyelitis.
Heel Bursitis vs. Plantar Fasciitis
Plantar fasciitis is inflammation at the bottom of the foot, affecting the plantar fascia. It’s an overuse injury, unlike bursitis, but can cause similar pain.
— By Mathieu Rees
