Bursae are situated in various locations throughout the body where friction between tissues commonly occurs. These sacs are designed to help reduce 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. In fact, the body sometimes creates bursal sacs in
response to trauma or tissue damage.
The most common cause of bursitis is repeated physical activity, but it can flare up for no known reason. It can also be caused by trauma, rheumatoid arthritis, gout, and acute or chronic
Symptoms of bursitis usually occur after rest and relaxation. Upon activity there is usually more intense pain in the area of the bursa. The common areas to have a bursitis in the foot are in the
bottom of the heel, behind the heel near the attachment of the Achilles Tendon as well as along the side of a bunion. A bursa may also form in multiple areas especially along the metatarsal heads, or
"ball" of your foot. You may actually feel the sac like fluid when rubbing the area of pain.
Bursitis is usually diagnosed after a careful physical examination and a full review of your medical history. If you garden and spend a lot of time on your knees, or if you have rheumatoid arthritis,
tell your doctor, this information can be very helpful. During the physical exam, he or she will press on different spots around the joint that hurts. The goal is to locate the specific bursa that is
causing the problem. The doctor will also test your range of motion in the affected joint. Other tests usually aren?t required to diagnose bursitis, but your doctor may suggest an MRI, X-ray or
ultrasound to rule out other potential causes of pain.
Non Surgical Treatment
Medications may be used to reduce the inflammation and pain of retrocalcaneal bursitis. Nonsteroidal anti-inflammatory drugs such as ibuprofen, naproxen and ketoprofen can be purchased without a
prescription and used to treat mild to moderate pain. These drugs are often used in combination with a physical therapy program or other retrocalcaneal bursitis treatments.
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.