Do you experience pain at the back of your heel? Is the back of your heel red and swollen? And you were told that it might Achilles Tendonitis? But so far treatment for Achilles Tendonitis does not seem to be working? You might be suffering instead from Retrocalcaneal Bursitis.
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 at the back of the heel, especially with jumping, hopping, tip-toeing, walking or running uphill or on soft surfaces. If tendonitis is also present, the pain can radiate away from the bursa. Direct pressure on the bursa will exacerbate the pain and should be avoided if possible. Tenderness and swelling which might make it difficult to wear certain shoes on the feet. As the bursa becomes more inflamed you will experience swelling and warmth. In severe cases, the bursa will appear as a bump, called a "pump bump", and is usually red, and extremely tender. Swelling can cause difficulties moving as the range of motion in the ankle can be affected. Limping due to the pain may occur. If you press on both sides of the inflamed heel, there may be a firm spongy feeling. Weakness in the tendons and muscles surrounding the bursa can develop as the pain worsens and the inflammation in the area spreads. Possibly a fever if you are suffering from septic bursitis (You will need to see a doctor for medication to get rid of the infection). Pain at the back of the heel makes it difficult to continue wearing shoes, especially high heels with straps or shoes that don't fit properly.
Medical examination is not necessarily required in light cases where the tenderness is minimal. In all cases where smooth improvement is not experienced, medical attention should be sought as soon as possible to exclude a (partial) rupture of the Achilles tendon or rupture of the soleus muscle. This situation is best determined by use of ultrasound scanning, as a number of injuries requiring treatment can easily be overlooked during a clinical examination (Ultrasonic image). Ultrasound scanning enables an evaluation of the extent of the change in the tendon, inflammation of the tendon (tendinitis), development of cicatricial tissue (tendinosis), calcification, inflammation of the tissue surrounding the tendon (peritendinitis), inflammation of the bursa (bursitis), as well as (partial) rupture.
Non Surgical Treatment
The most important part of treating bursitis is resting your Achilles tendon while the bursa heals. Resting your ankle as much as possible may decrease swelling and keep the bursitis from getting worse. When the pain decreases, begin normal, slow movements. Ice causes blood vessels to constrict (get small) which helps decrease inflammation (swelling, pain, and redness). Put crushed ice in a plastic bag or use a bag of frozen corn or peas. Cover it with a towel. Put this on your heel for 15 to 20 minutes, three to four times each day. Do not sleep on the ice pack because you can get frostbite. After two or three days, you may try using heat to decrease pain and stiffness. Use a hot water bottle, heating pad, whirlpool or warm, moist compress. To make a compress, dip a clean washcloth in warm water. Wring out the extra water and put it on your heel for 15 to 20 minutes, three to four times each day. Your caregiver may tell you to switch between treating your heel with ice packs and heat treatments. Follow the caregiver's directions carefully when doing these treatments.
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.