A lesser known type of heel pain is a condition called Bursitis of the Heel. A bursa is a fluid-filled sac that cushions the muscles, tendons and bones in our joints. It helps keep them from rubbing
against each other and reduces friction in the areas around the joints. Bursitis is Latin for inflammation of the bursa. Repeated movement and pressure on the bursa can cause it to swell and become
inflamed. Trauma, infection or crystal deposits can also cause Bursitis. The joints that are usually affected by bursitis are the large joints such as the shoulder, hip and knee but in some cases
also the back of the heel.
Causes of bursitis can be from any form of friction between bone and the soft tissues. The most common cause is due to abnormal pronation.
Pain and tenderness are common symptoms. If the affected joint is close to the skin, as with the shoulder, knee, elbow, or Achilles tendon, swelling and redness are seen and the area may feel warm to
the touch. The bursae around the hip joint are deeper, and swelling is not obvious. Movement may be limited and is painful. In the shoulder, it may be difficult to raise the arm out from the side of
the body. Putting on a jacket or combing the hair becomes a troublesome activity. In acute bursitis symptoms appear suddenly, with chronic bursitis, pain, tenderness, and limited movement reappear
after exercise or strain.
The diagnosis is based on the symptoms and an examination. For anterior Achilles tendon bursitis, doctors use x-rays to rule out a fracture of the heel bone or damage to the heel bone caused by
rheumatoid arthritis or other inflammatory arthritis.
Non Surgical Treatment
Home treatment is often enough to reduce pain and let the bursa heal. Your doctor may suggest physical therapy to strengthen the muscles around your joints. Rest the affected area. Avoid any activity
or direct pressure that may cause pain. Apply ice or cold packs as soon as you notice pain in your muscles or near a joint. Apply ice 10 to 15 minutes at a time, as often as twice an hour, for 3 days
(72 hours). You can try heat, or alternating heat and ice, after the first 72 hours. Use pain relievers. Use nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, to reduce
pain and inflammation. NSAIDs come in pills and also in a cream that you rub over the sore area. Acetaminophen (such as Tylenol) can also help with pain. Don't rely on medicine to relieve pain so
that you can keep overusing the joint. Do range-of-motion exercises each day. If your bursitis is in or near a joint, gently move the joint through its full range of motion, even during the time that
you are resting the joint area. This will prevent stiffness. As the pain goes away, add other exercises to strengthen the muscles around your joint. Avoid tobacco smoke.Smoking delays wound and
tissue healing. If you have severe bursitis, your doctor may use a needle to remove extra fluid from the bursa. You might wear a pressure bandage on the area. Your doctor may also give you a shot of
medicine to reduce swelling. Some people need surgery to drain or remove the bursa. Sometimes the fluid in the bursa can get infected. If this happens, you may need antibiotics. Bursitis is likely to
improve in a few days or weeks if you rest and treat the affected area. But it may return if you don't stretch and strengthen the muscles around the joint and change the way you do some
Bursectomy is a surgical procedure used to remove an inflamed or infected bursa, which is a fluid-filled sac that reduces friction between tissues of the body. Because retrocalcaneal bursitis can
cause chronic inflammation, pain and discomfort, bursectomy may be used as a treatment for the condition when it is persistent and cannot be relived with other treatments. During this procedure, a
surgeon makes small incisions so that a camera may be inserted into the joint. This camera is called an arthroscope. Another small incision is made so that surgical instruments can be inserted to
remove the inflamed bursa.