Retrocalcaneal bursitis and Achilles bursitis are the most widely spread types of ankle / heel bursitis out there. However, there are several bursa lubrication fluid sacs behind the heel bone
protecting this area that may become irritated, inflammed and painful.
The most common causative organism is Staphylococcus aureus (80% of cases), followed by streptococci. However, many other organisms have been implicated in septic bursitis, including mycobacteria
(both tuberculous and nontuberculous strains), fungi (Candida), and algae (Prototheca wickerhamii). Factors predisposing to infection include diabetes mellitus, steroid therapy, uremia, alcoholism,
skin disease, and trauma. A history of noninfectious inflammation of the bursa also increases the risk of septic bursitis.
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).
Your doctor will check for bursitis by asking questions about your past health and recent activities and by examining the area. If your symptoms are severe or get worse even after treatment, you may
need other tests. Your doctor may drain fluid from the bursa through a needle (aspiration) and test it for infection. Or you may need X-rays, an MRI, or an ultrasound.
Non Surgical Treatment
Non-operative treatment is the standard approach to treating posterior heel pain. It is highly desirable to treat this condition non-operatively, as operative treatment is often associated with a
prolonged recovery. Traditional non-operative treatment includes the following. Heel Lift or the Use of a Shoe with a Moderate Heel. Walking barefoot or in a flat-soled shoe increases the tension on
the insertion of the Achilles tendon. Using a heel lift or a shoe with a moderate heel can help reduce the stress on the tendon and decrease the irritation caused by this condition.
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.