Retrocalcaneal bursitis most commonly occurs as s result of repetitive activity that encourages the calf muscles to tighten and shorten from overuse, like repetitively wearing high heels, running and
even wearing tight shoes that pinch at the back of the heel. Symptoms normally include a constant dull ache or burning pain at the back of the heel that is aggravated by any touch or pressure from
tight shoes or movement of the ankle joint. There will normally be noticeable swelling around the back of the heel. In cases of bursitis caused by infection the skin around the affected joint will
appear red and will feel incredibly warm to the touch. Additional symptoms are a high temperature and feverish chills. Retrocalcaneal bursitis is very similar to Achilles bursitis as the bursae are
very close in proximity and symptoms are almost identical however retrocalcaneal bursitis is a lot more common.
Bursitis, tendinitis, and other soft tissue rheumatic syndromes typically result from one or more factors. These include: Play or work activities that cause overuse or injury to the joint areas
Incorrect posture Stress on the soft tissues from an abnormal or poorly positioned joint or bone (such as leg length differences or arthritis in a joint) Other diseases or conditions (rheumatoid
arthritis, gout, psoriasis, thyroid disease, or an unusual drug reaction) Infection.
Pain when activating the Achilles tendon (running and jumping) and when applying pressure at the point of attachment of the tendon on the heel bone. Contrary to the tenderness occurring with
inflammation of the Achilles tendon, the tenderness is localised to the point of attachment to the heel bone.
Your doctor will examine you, including an evaluation of your gait, while you are barefoot, your doctor will ask you to stand still and to walk in order to evaluate how your foot moves as you walk.
An examination of your feet. Your doctor may compare your feet for any differences between them. Then your doctor may examine your painful foot for signs of tenderness, swelling, discoloration,
muscle weakness and decreased range of motion. A neurological examination. The nerves and muscles may be evaluated by checking strength, sensation and reflexes. In addition to examining you, your
health care professional may want to examine your shoes. Signs of excessive wear in certain parts of a shoe can provide valuable clues to problems in the way you walk and poor bone alignment.
Depending on the results of your physical examination, you may need foot X-rays or other diagnostic tests.
Non Surgical Treatment
During the initial acute phase of the condition, patients should apply ice to the back of the heel for 15 to 20 minutes and follow the R.I.C.E.R regime. Avoid activities that cause pain. Gradual
progressive stretching of the calf muscle and Achilles tendon is also advocated. Changing the footwear. Wearing an open-backed shoe may help relieve pressure on the affected region. For those whose
symptoms were caused by a sudden change from wearing high-heeled shoes to flat shoes, the temporary use of footwear with a heel height in between may be helpful. Inserting a heel cup in the shoe may
help to raise the inflamed region slightly above the shoe?s restricting heel counter and relieve the pain. It is advisable to also insert the heel cup into the other shoe to avoid any leg-leg
discrepancies that can lead to other problems. Training frequency and intensity should be gradually progressed with adequate rest between trainings.
Surgery. Though rare, particularly challenging cases of retrocalcaneal bursitis might warrant a bursectomy, in which the troublesome bursa is removed from the back of the ankle. Surgery can be
effective, but operating on this boney area can cause complications, such as trouble with skin healing at the incision site. In addition to removing the bursa, a doctor may use the surgery to treat
another condition associated with the retrocalcaneal bursitis. For example, a surgeon may remove a sliver of bone from the back of the heel to alter foot mechanics and reduce future friction. Any
bone spurs located where the Achilles attaches to the heel may also be removed. Regardless of the conservative treatment that is provided, it is important to wait until all pain and swelling around
the back of the heel is gone before resuming activities. This may take several weeks. Once symptoms are gone, a patient may make a gradual return to his or her activity level before their bursitis
symptoms began. Returning to activities that cause friction or stress on the bursa before it is healed will likely cause bursitis symptoms to flare up again.