St. Luke's Hospital
Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
Find a Physician Payment Options Locations & Directions
Follow us on: facebook twitter Mobile Email Page Email Page Print Page Print Page Increase Font Size Decrease Font Size Font Size
America's 50 Best Hospitals
Meet the Doctor
Spirit of Women
Community Health Needs Assessment
Home > Health Information

Multimedia Encyclopedia

    Print-Friendly
    Bookmarks

    Bursitis of the heel

    Insertional heel pain; Retrocalcaneal bursitis

    Bursitis of the heel is swelling of the fluid-filled sac (bursa) at the back of the heel bone under the Achilles tendon.

    Causes

    A bursa acts as a cushion and lubricant between tendons or muscles sliding over bone. There are bursas around most large joints in the body, including the ankle.

    The retrocalcaneal bursa is located in the back of the ankle by the heel. It is where the large Achilles tendon connects the calf muscles to the heel bone.

    Repeated or too much use of the ankle can cause this bursa to become irritated and inflamed. Possible causes are too much walking, running, or jumping.

    This condition is usually linked to Achilles tendinitis. Sometimes retrocalcaneal bursitis may be mistaken for Achilles tendinitis.

    Risks for this condition include starting an aggressive workout schedule, or suddenly increasing activity level without the right conditioning.

    Symptoms

    • Pain in the heel, especially with walking, running, or when the area is touched
    • Pain may get worse when rising on the toes (standing on tiptoes)
    • Red, warm skin over the back of the heel

    Exams and Tests

    Your health care provider will take a history to find out if you have symptoms of retrocalcaneal bursitis. Examining your ankle can find the location of the pain. The physician will look for tenderness and redness in the back of the heel.

    The pain may be worse when the doctor bends the ankle upward (dorsiflex). Or, the pain may be worse when you rise on your toes.

    You will not usually need imaging studies such as x-ray and MRI at first. If the first treatment does not improve the symptoms, your health care provider may recommend these tests. MRI may show inflammation.

    Treatment

    Your health care provider may recommend the following treatments:

    • Avoid activities that cause pain.
    • Ice the heel several times a day.
    • Take nonsteroidal anti-inflammatory medications (for example, ibuprofen).
    • Try over-the-counter or custom heel wedges to help decrease the stress on the heel.
    • Try ultrasound treatment during physical therapy to reduce inflammation.
    • Use physical therapy to improve flexibility and strength around the ankle, which can help the bursitis improve and prevent it from coming back.

    If these treatments don't work, your health care provider may inject a small amount of steroids into the bursa. After the inection, you should avoid stretching the tendon too much because it can break open (rupture).

    If the condition is connected with Achilles tendinitis, casting the ankle for several weeks to keep it from moving can be effective. Very rarely, surgery may be needed to remove the inflamed bursa.

    Outlook (Prognosis)

    This condition usually gets better in several weeks with the proper treatment.

    When to Contact a Medical Professional

    If you have heel pain or symptoms of retrocalcaneal bursitis that do not improve with rest, contact your health care provider for evaluation and treatment.

    Prevention

    Maintain proper form when exercising, as well as good flexibility and strength around the ankle to help prevent this condition.

    Proper stretching of the Achilles tendon helps prevent injury.

    References

    Wapner KL, Parekh SG. Heel pain. In: DeLee JC, Drez D Jr., Miller MD, eds. DeLee and Drez's Orthopaedic Sports Medicine. 3rd ed. Philadelphia, Pa: Saunders Elsevier;2009:section F.

    Aranow MS. Posterior heel pain (retrocalcaneal bursitis, insertional and noninsertional Achilles tendinopathy). Clin Podiatr Med Surg. 2005;22:19-43.

    BACK TO TOP

    • Flexibility exercise

      illustration

    • Retrocalcaneal bursitis

      illustration

      • Flexibility exercise

        illustration

      • Retrocalcaneal bursitis

        illustration

      A Closer Look

        Self Care

          Tests for Bursitis of the heel

            Review Date: 8/11/2012

            Reviewed By: David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc., and C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery.

            The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
            adam.com

            A.D.A.M. content is best viewed in IE9 or above, Fire Fox and chrome browser.


            Back  |  Top
            About Us
            Contact Us
            History
            Mission
            Locations & Directions
            Quality Reports
            Annual Reports
            Honors & Awards
            Community Health Needs
            Assessment

            Newsroom
            Services
            Brain & Spine
            Cancer
            Heart
            Maternity
            Orthopedics
            Pulmonary
            Sleep Medicine
            Urgent Care
            Women's Services
            All Services
            Patients & Visitors
            Locations & Directions
            Find a Physician
            Tour St. Luke's
            Patient & Visitor Information
            Contact Us
            Payment Options
            Financial Assistance
            Send a Card
            Mammogram Appointments
            Health Tools
            My Personal Health
            mystlukes
            Spirit of Women
            Health Information & Tools
            Clinical Trials
            Health Risk Assessments
            Employer Programs -
            Passport to Wellness

            Classes & Events
            Classes & Events
            Spirit of Women
            Donate & Volunteer
            Giving Opportunities
            Volunteer
            Physicians & Employees
            For Physicians
            Remote Access
            Medical Residency Information
            Pharmacy Residency Information
            Physician CPOE Training
            Careers
            Careers
            St. Luke's Hospital - 232 South Woods Mill Road - Chesterfield, MO 63017 Main Number: 314-434-1500 Emergency Dept: 314-205-6990 Patient Billing: 888-924-9200
            Copyright © St. Luke's Hospital Website Terms and Conditions  |  Privacy Policy  |  Patient Notice of Privacy Policies PDF Sitemap St. Luke's Mobile