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How to treat retrocalcaneal bursitis

Retrocalcaneal bursitis involves swelling of the retrocalcaneal bursa which is found at the back region of the heel bone known as calcaneal bone. The retrocalcaneal bursa is a slippery sac filled with fluids that functions as a padding and lubricant amidst the heel bone and the Achilles tendon.

The inflammation is usually caused by irritation of the bursa.  The irritation is due to certain types of activities and underlying conditions such as abnormality of the foot, arthritis, and the development of a boney prominence found in the calcaneal bone called Haglund’s deformity.

Symptoms of retrocalcaneal bursitis

  • Soft tissue swelling above the heel bone
  • Formation of a hard lump behind the heel
  • The back of the heel becomes red
  • Pain and tenderness of the affected area
  • Pain becomes severe when pointing the foot or flexed
  • Pain when standing on the toes
  • Fever and chills
    retrocalcaneal bursitis

    Pain becomes severe when pointing the foot or flexed

Causes

  • Repetitive use of the ankle such as excessive jumping, walking or running
  • Sudden intensifying the exercise program without proper stretching and conditioning of the muscles.
  • Wearing ill fitting footwear
  • Deformity of the ankle or foot
  • Previous trauma or injury to the heel
  • Underlying conditions such as osteoarthritis, rheumatoid arthritis, pseudogout and gout.
  • Infection through a cut, blisters, puncture and an insect bite
  • Having a history of inflammation of the bursa increases the chance of getting it again.

Treatment

  • Wear comfortable and supportive shoes. Avoid shoes that press against the back of the heel. Wear shoes that have an “Achilles notch.” It is a groove in the collar at the back of the shoes that protects the Achilles tendon. All running shoes are designed with an Achilles notch.
  • Take frequent resting of the foot to lessen the inflammation.
  • Apply ice on the affected area in the form of an ice pack or compress for at least 10-15 minutes to lessen the pain and the inflammation. Avoid ice directly on the skin to prevent ice burn and worsen the condition. Wrap ice in a towel or a cloth before applying to the area.
  • Wrap the area using compression bandage such as ACE bandage to lessen the inflammation. Avoid wrapping the area too tight to prevent problems with circulation.
  • Elevate the affected heel above the level of the heart to lessen the inflammation and the pain. Another alternative is raising the area in couple of pillows to keep it elevated.
  • Take the prescribed over-the-counter pain medications such as ibuprofen and naproxen to lessen the inflammation and the pain caused by retrocalcaneal bursitis.
  • Wear the prescribed orthotic devices such as heel insert for better mechanics in the foot and lessen irritation on the area.
  • Perform regular stretching of the Achilles tendon with the help of the physical therapist to lessen the pain. Regular stretching of the affected area reduces the chances of recurrence.

Disclaimer / More Information

The material posted on this page on retrocalcaneal bursitis is for learning purposes only. Learn to recognize and manage this joint condition by taking a first aid and CPR class with one of our training providers.

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