Retrocalcaneal bursitis refers to a condition which involves the inflammation of the bursae around the heel. Bursae are the sacs which are filled with fluid, and form around the joints. The bursae near the heel are located behind the Achilles tendon, above its attachment to the heel bone.
Retrocalcaneal bursitis is seen to be common in athletes, especially in sports which place a lot of pressure on the heel, such as ballet, gymnastics and running. There is sometimes confusion between retrocalcaneal bursitis and Achilles tendonitis. On some occasions, the two conditions can be present at the same time.
The predominant symptom of retrocalcaneal bursitis is overuse of the heel, and the ankle region. It can also occur due to not warming up adequately ahead of exercise, quickly increasing physical activity, walking or exercising in poorly fitting shoes, or footwear which is too tight such as high heels. Arthritis has been found to cause retrocalcaneal bursitis.
Other potential causes include; infection, Haglund's deformity, gout, the ageing process, muscle tightness, and a job or activity which repeatedly places strain on the ankle joint.
The predominant symptom of retrocalcaneal bursitis is heel pain which often arises when pressure is placed on the heel.
Among the other symptoms of retrocalcaneal bursitis are; pain when leaning back and placing pressure on the heels; swelling in the heel region; skin which appears red or feels warm at the back of the heel; calf pain when walking or running; inhibited range of motion; uncomfortable shoes; a cracking sound from the foot when moving it; and stiffness.
There are many non-surgical, home care options for treating retrocalcaneal bursitis which can sometimes be effective. These can include; resting the ankles and heels, elevating the feet, and using indirect ice treatment on the heel and ankles. Also using a slight heel raise and wearing footwear without a heel counter can be helpful.
Over the counter medications which can be effective in reducing pain include nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen.
There are some retrocalcaneal bursitis symptoms which could indicate an infection, and require urgent medical attention. These include; a rash and swelling in the heel area, a shooting pain, heel pain along with a fever which is higher than 100.4°F (38°C).
Surgery can be recommended to treat challenging cases of retrocalcaneal bursitis. This procedure involves the removal of the troublesome bursa and any aggravating bony prominences. At the Sussex Foot & Ankle Clinic this is carried out as a day case procedure with immediate weight bearing allowed. Almost all cases are now done endoscopically (keyhole) with just two small incisions used. After two weeks, the two small sutures are removed and physiotherapy can begin. Gradual resumption of normal activity can begin.
As with all foot surgery it is common for swelling to persist for some months after surgery and is completely normal. This swelling will eventually completely subside with time and can take up to 12 months but often goes well before this.