The most common bursa to be inflamed in the foot is the retrocalcaneal bursa (also referred to as the subtendinous calcaneal bursa). Located between the Achilles tendon and the heel bone (calcaneus),
this is a "true" bursa that is present from birth. It acts as a cushion to protect the Achilles tendon from friction against the heel bone. Also commonly affected, the subcutaneous calcaneal bursa
(also referred to as the Achilles bursa), located between the Achilles tendon and the skin, sits a little lower down the ankle towards the heel than the retrocalcaneal bursa. This bursa develops as
you age, an "adventitious" bursa, to protect the tendon from friction at the back of the heel.
Overtraining in an athlete. Tight or poorly fitting shoes that produce excessive pressure at the posterior heel. Haglund deformity. Altered joint axis. Inflammation of the calcaneal bursae is most
commonly caused by repetitive (cumulative) trauma or overuse, and the condition is aggravated by pressure, such as when athletes wear tight-fitting shoes. Retrocalcaneal bursitis may also be
associated with conditions such as gout, rheumatoid arthritis, and seronegative spondyloarthropathies. In some cases, retrocalcaneal bursitis may be caused by bursal impingement between the Achilles
tendon and an excessively prominent posterosuperior aspect of the calcaneus (Haglund deformity). In Haglund disease, impingement occurs during ankle dorsiflexion.
Pain when activating the Achilles tendon (running and jumping) and when applying pressure at the point of attachment of the tendon on the heel bone. Contrary to the tenderness occurring with
inflammation of the Achilles tendon, the tenderness is localised to the point of attachment to the heel bone.
The doctor will discuss your symptoms and visually assess the bones and soft tissue in your foot. If a soft tissue injury is suspected, an MRI will likely be done to view where and how much the
damage is in your ankle. An x-ray may be recommended to rule out a bone spur or other foreign body as the cause of your ankle pain. As the subcutaneous bursa is close to the surface of the skin, it
is more susceptible to septic, or infectious, bursitis caused by a cut or scrape at the back of the heel. Septic bursitis required antibiotics to get rid of the infection. Your doctor will be able to
determine whether there is an infection or not by drawing a small sample of the bursa fluid with a needle.
Non Surgical Treatment
Specific treatment for bursitis will be determined by your doctor based on your age, overall health, and medical history. Extent of the condition. Your tolerance for specific medications, procedures,
or therapies. Expectations for the course of the condition. Your opinion or preference. The treatment of any bursitis depends on whether or not it involves infection. Aseptic bursitis. A
noninfectious condition caused by inflammation resulting from local soft-tissue trauma or strain injury. Treatment may include R.I.C.E. Rest, Ice, Compression, and Elevation. Anti-inflammatory and
pain medications, such as ibuprofen or aspirin. Aspiration of the bursa fluid for evaluation in the laboratory. Injection of cortisone into the affected area. Rest. Splints.
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