Infracalcaneal bursitis is inflammation of a bursa-a fluid-filled sac-below your calcaneus, or heel bone. Bursae are situated in various locations throughout your body where friction between tissues
commonly occurs, and these sacs are designed to help reduce this friction and prevent pain. Repetitive movements or prolonged and excessive pressure are the most common causes of bursal inflammation,
though traumatic injury may also cause this painful problem. Indeed, your body sometimes creates bursal sacs in response to trauma or tissue damage. Infracalcaneal bursitis can sometimes be difficult
to differentiate from plantar fasciosis-another condition that causes pain below the heel. The key difference is that infracalcaneal bursitis tends to be worse at the end of the day whereas plantar
fascia pain tends to be worse in the morning, immediately upon waking.
Overusing your calves, ankles and heels during inappropriate or excessive training or doing repetitive motions for prolonged periods of time can contribute to the development of the this painful
ankle Achilles and retrocalcaneal bursitis aliment. Bursitis in this part of the body often occurs in professional or recreational athletes. Walking, running and jumping can do some damage. (I loved
to skip rope before I suffered my severe hip bursitis.). Injury. This condition may also develop following trauma such as a direct, hard hit to your heel. Footwear. Poorly fitting shoes that are too
tight, too large or have heels can all cause excessive pressure or friction over the bursa in the heel. Infection. Medical problems, such as rheumatoid arthritis or gout, sometimes lead to bursitis.
It is not unusual to have Achilles bursitis and tendonitis (inflamed tendon) at the same time. Ankle bursitis is often a genetic condition where you simply inherited a foot type, for example a heel
bone with a prominence, high arch or tight Achilles tendon, that is more prone to the mechanical irritation that leads to the bursitis. Muscle weakness, joint stiffness and poor flexibility
(particularly of the calf muscles) are certainly contributing factors too.
Pain or tenderness at the back of the heel around the Achilles region. Increased pain during activities with strong, repetitive calf contractions, walking (uphill), stair climbing, running, jumping.
Pain may be worse with rest after activity (that night or the next morning) or at the beginning of the excercise. Pain when wearing shoes and the heel is getting rubbed. Bump forming on the back of
the heel. Limping. Stiffness. Decreased range of motion. Redness and warmth (if the bursa gets infected).
When you suspect you have retrocalcaneal bursitis, your foot doctor will begin by taking a complete history of the condition. A physical exam will also be performed. X-rays are usually taken on the
first visit as well to determine the shape of the heel bone, joint alignment in the rearfoot, and to look for calcium deposits in the Achilles tendon. The history, exam and x-rays may sufficient for
your foot surgeon to get an idea of the treatment that will be required. In some cases, it may be necessary to get an ultrasound or MRI to further evaluate the Achilles tendon or its associated
bursa. While calcium deposits can show up on xray, the inflammation in the tendon and bursa will show up much better on ultrasound and MRI. The results of these tests can usually be explained on the
first visit. You can then have a full understanding of how the problem started, what you can do to treat prevent it from getting worse/ You will also know which treatment will be most helpful in
making your heel pain go away.
Non Surgical Treatment
With anterior and posterior Achilles tendon bursitis, applying warm or cool compresses to the area and using nonsteroidal anti-inflammatory drugs (NSAIDs) can temporarily relieve the pain and
inflammation, as can injections of a corticosteroid/anesthetic mixture into the inflamed bursa. The doctor is careful not to inject the mixture into the tendon. After this treatment, the person
should rest. When these treatments are not effective, part of the heel bone may need to be surgically removed.
Surgery to remove the damaged bursa may be performed in extreme cases. If the bursitis is caused by an infection, then additional treatment is needed. Septic bursitis is caused by the presence of a
pus-forming organism, usually staphylococcus aureus. This is confirmed by examining a sample of the fluid in the bursa and requires treatment with antibiotics taken by mouth, injected into a muscle
or into a vein (intravenously). The bursa will also need to be drained by needle two or three times over the first week of treatment. When a patient has such a serious infection, there may be
underlying causes. There could be undiscovered diabetes, or an inefficient immune system caused by human immunodeficiency virus infection (HIV).