Heel bursitis is specifically the inflammation of the retrocalcaneal bursa, located at the back of the heel, under the Achilles tendon. There are a handful of factors that put you at risk for
developing heel bursitis. Long distance runners are prone to heel bursitis, due to repeated stress and pounding upon the heel joint. Engaging in activities such as running, bicycling, walking,
jumping, and stair climbing for extended periods of time can overwork the heel joints and start to irritate the bursae. Suddenly changing to a high-intensity workout regime puts a lot of stress on
the heel, making it vulnerable to injury. Hard blows/bumps to the heel can immediately damage the bursae, leading to swelling and inflammation. Training at high intensities without stretching and
warming up can also contribute to the development of heel bursitis. Even improper footwear can be a big factor. Some other conditions can put you at risk as well, such as: tarsal tunnel syndrome,
rheumatoid arthritis, plantar fasciitis, muscle weakness, joint stiffness, and heel spurs. It is very important to get a professional diagnosis if you are having heel pain because heel bursitis is
often confused for Achilles tendonitis, and the proper treatments are very different. The pain could also be plantar fasciitis or general heel pain syndrome.
Bursitis is caused by overuse or excessive pressure on the joint, injury, infection, or an underlying condition, such as osteoarthritis, rheumatoid arthritis, gout, pseudogout, or ankylosing
spondylitis. When bursitis is caused by an underlying condition, the condition must be treated along with the bursitis. When bursitis is caused by infection, called septic bursitis, medical treatment
and antibiotics are necessary.
Symptoms of Achilles bursitis are often mistaken for Achilles tendinitis because of the location of the pain at the back of the heel. When you suffer from Achilles bursitis you will experience some
or all of the following symptoms which are most noticeable when you begin activity after resting. High heels can add pressure on the retrocalcaneal bursa, subcutaneous calcaneal bursa, and Achilles
Gram stain. A lab test called a Gram stain is used to determine if certain troublesome bacteria are present. Not all bacteria can be identified with a Gram stain, however, so even if the test comes
back negative, septic bursitis cannot be completely ruled out. White blood cell count. An elevated number of white blood cells in the bursa's synovial fluid indicates an infection. Glucose levels
test. Glucose levels that are significantly lower than normal may indicate infection.
Non Surgical Treatment
If you follow these steps, most attacks of bursitis should subside in four or five days and all symptoms should be gone within two weeks. Rest the body part that hurts. If you suspect that one
activity has caused the pain, stop it until the pain is entirely gone. A sling, splint, or padding may be needed to protect the area from possible bumps or irritation. Try over-the-counter pain
relievers. Nonprescription NSAIDs (aspirin, ibuprofen, and naproxen) will help reduce pain and swelling, though they won?t accelerate healing. Acetaminophen will help with pain but it doesn?t reduce
inflammation. Ice it, then heat it. Apply ice packs during the first two days to bring down swelling. Then use heat-warm baths or a heating pad (on a medium or low setting)-to ease pain and stimulate
blood flow. Don?t push it. Resume exercising only after you feel better. Start with gentle activity. Skip the liniments. Liniments and balms are no help for bursitis. Liniments don?t penetrate deeply
enough to treat bursitis, they mainly warm the skin and make it tingle, thus distracting attention from the pain beneath. Massage is likely to make matters worse. Undergo physical therapy. Physical
therapy strengthens joint muscles that have been affected by bursitis and may help prevent the bursitis from getting worse.
Do not run if you have pain. When you begin running again, avoid running fast uphill or downhill until the tendon is fully healed. Start exercising when caregivers say that it is OK. Slowly start
exercise such as bicycling when caregivers say it is OK. When doing exercises that put pressure on the ankles, such as running or walking, exercise on flat, even surfaces. Avoid doing these exercises
on very hard surfaces such as asphalt or concrete. Stretch before exercising. Always warm up your muscles and stretch gently before exercising. Do cool down exercises when you are finished. This will
loosen your muscles and decrease stress on your heel. Wear heel protectors. Use soft foam or felt heel pads (wedges or cups) to help decrease pressure against your heel. Ask your caregiver which heel
pads are the best for you. Wear well-fitting shoes. Buy running or exercise shoes that support and fit your feet well. Do not wear low-cut shoes. Talk to your caregiver or go to a special exercise
footwear store to get well-fitting athletic shoes. Ask your caregiver if you should wear specially-made shoe inserts called orthotics (or-THOT-iks). Orthotics can line up your feet in your shoes to
help you run, walk and exercise correctly.