Plantar calcaneal bursitis is a medical condition in which there is inflammation of the plantar calcaneal bursa, a spongy fluid filled sac that cushions the fascia of the heel and the calcaneus (heel bone). It is characterized by swelling and tenderness of the central plantar heel area. It is sometimes called ‘Policeman’s heel’. It sometimes was, and should not be, confused with plantar fasciitis, which is inflammation of the plantar fascia and can affect any part of the foot.
The causes and risk factors of retrocalcaneal bursitis are listed below. Identifying the underlying reason the bursa is inflamed will help set a course for treatment. Repetitive use of the ankle. Retrocalcaneal bursitis is often caused by frequent “mini-traumas.” These mini-traumas are often due to excessive walking, jumping, or running. Running uphill, which causes the foot to flex considerably, can be especially irritating to the retrocalcaneal bursae. People who suddenly intensify their exercise programs without adequate stretching and muscle conditioning may get retrocalcaneal bursitis. In general, it is often associated with over use of the Achilles attachment, the area where the Achilles tendon fibers attach to the heel.
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. The symptoms of bursitis vary depending on whether the bursitis is the result of injury or an underlying health condition or from infection. From normal overuse and injury the pain is normally a constant dull ache or burning pain at the back of the heel that is aggravated by any touch, pressure like tight shoes or movement of the joint. There will normally be notable swelling around the back of the heel. In other cases where the bursa lies deep under the skin in the hip or shoulder, swelling might not be visible. Movement of the ankle and foot will be stiff, especially in the mornings and after any activity involving the elbow. All of these symptoms are experienced with septic bursitis with the addition of a high temperature of 38?C or over and feverish chills. The skin around the affected joint will also appear to be red and will feel incredibly warm to the touch. In cases of septic bursitis it is important that you seek medical attention. With injury induced bursitis if symptoms are still persisting after 2 weeks then report to your GP.
Before making a diagnosis of retrocalcaneal bursitis, a doctor must rule out other possible problems, such as arthritis, a fracture or tumor. A doctor also will try to determine if the Achilles tendon itself is a source of pain. To make a diagnosis, a doctor will use some or all of the diagnostic tools below Patient interview. A doctor will ask a patient about medical history, and to describe the onset of his or her symptoms, the pattern of pain and swelling, and how symptoms affect lifestyle. For example, doctors may ask patients what types of shoes they wear and what they do for exercise. A patient’s reported symptoms are important to diagnosis and treatment. The doctor will also ask what home treatments have helped the condition. Physical exam. A doctor will examine the patient’s foot, noting swelling, tenderness and pain points, and range of motion. The doctor also may ask the patient to point and flex the feet and stand on his or her toes.
Non Surgical Treatment
Most patients with achilles and retrocalcaneal bursitis heal well with appropriate physiotherapy and other usual bursitis conventional and natural cures being administered. Specific treatments for ankle / heel bursitis may include footwear correction. Get well-fitting, soft-backed (or even open-backed whenever possible) shoes for both day to day wear and exercise. High-heels should really be a no no or worn sparingly, ladies. Heel protectors. Heel pads and heel lifts are great simple solutions to cushion and protect the Achilles area from the irritation of the shoes. Orthotics. There are various orthotic devices out there (some only available over-the-counter). One example is a custom arch suppport. These can control abnormal motion in your feet by lining them up correctly in your shoes to help you move in the right matter so the bursitis heals faster and does not return back again. Exercise modification Stretch your heel, mainly Achilles tendon, frequently, particularly before and after excercise or prolonged sitting. If you are a jogger, try to run on softer surfaces (no hard concrete, please). Running uphill training is best to be avoided by Achilles and retrocalcaneal bursitis sufferers.
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.