Retrocalcaneal Bursitis: What it is and how to treat it
Step into the world of foot health as we explore a common yet often overlooked ailment – retrocalcaneal bursitis. Our journey takes us to the back of the heel, just deep to the Achilles tendon, where a small, fluid-filled sac known as the retrocalcaneal bursa plays a crucial role in smooth movement. In this blog, we'll delve into the intricacies of this condition, understanding its causes, symptoms, and most importantly, how to alleviate discomfort.
Retrocalcaneal bursitis is quite common, especially in athletes. The condition refers to inflammation of the bursa, predominantly caused by increased stress due to overuse during physical activities like running. If you’ve not warmed up sufficiently before working out or playing a sport, the sudden stress on your heel can also cause retrocalcaneal bursitis.
Other causes can be wearing shoes that do not fit correctly - in fact people who already have retrocalcaneal bursitis will see worsened symptoms if they continue to wear heels or ill-fitted shoes for a prolonged period. A direct impact such as a shopping trolley hitting the back of your heel can also irritate and inflame the bursa, causing considerable pain, which in turn is called a bursitis.
Although rare, retrocalcaneal bursitis may also be caused by an infection, or by systemic inflammatory conditions such as rheumatoid arthritis. You have a chance of getting retrocalcaneal bursitis if you are over age 65, play sports, have tight muscles, or don't warm up and stretch properly before playing a sport or exercising.
Symptoms include stiffness in the foot, loss of movement, cracking sounds when you flex your foot, shoes feeling uncomfortable, pain in the calf muscles during walking or running, swelling of the heel and redness on the skin surrounding the heel.
Diagnosing retrocalcaneal bursitis typically involves a combination of medical history assessment, physical examination, and sometimes imaging studies such as x-ray and ultrasound are used to rule out other conditions and to visualize the bursa and surrounding structures. It’s essential to consult with a healthcare professional to determine the most appropriate treatment plan based on individual circumstances and the severity of the condition.
Treatment for retrocalcaneal bursitis aims to reduce inflammation, alleviate pain, and prevent recurrence. Depending on the severity of the condition, treatment options may include:
Rest: Avoid activities that exacerbate symptoms, such as running or jumping, to allow the inflamed bursa to heal.
Ice therapy: Applying ice packs to the affected area for 15-20 minutes several times a day can help reduce pain and inflammation
Nonsteroidal anti-inflammatory drugs (NSAIDs): Over-the-counter medications like ibuprofen or naproxen can help relieve pain and reduce inflammation.
Physical Therapy: Specific exercises and stretches prescribed by a physical therapist can improve flexibility, strengthen surrounding muscles, and alleviate symptoms.
Orthotic devices: Shoe inserts or heel pads can help redistribute pressure away from the inflamed bursa and provide cushioning.
Footwear modifications: Wearing shoes with a cushioned heel and proper arch support can reduce pressure on the heel and Achilles tendon.
Immobilisation: In severe cases, wearing a walking boot or brace may be necessary to restrict movement and allow the bursa to heal.
Steroid Injections (of corticosteroids): Directly into the bursa can provide significant pain relief and reduce inflammation.
Extracorporeal shock wave therapy (ESWT): This non-invasive procedure uses shock waves to stimulate healing and reduce pain in the affected area.
Surgery: In rare cases where conservative treatments fail to provide relief, surgical removal of the inflamed bursa (bursectomy) may be considered.
Additionally, following preventive measures such as wearing appropriate footwear and gradually increasing activity levels can help prevent recurrence of retrocalcaneal.
However, bursitis can be a stubborn condition that does not always respond to conservative treatment and physiotherapy. As mentioned above, a steroid injection, also known as corticosteroid, is a potent anti-inflammatory and is very effective at reducing the pain and swelling associated with a bursitis. The steroid is combined with a local anaesthetic to ensure the procedure is relatively pain-free, and is carried out using ultrasound guidance to ensure the needle is placed in the correct place to get maximal pain relief. This then provides a pain-free window to progress your rehabilitation and return to sport/activity.
A patient will rarely need more than one injection, with one injection normally providing the pain relief required. It is worth noting that here at the Leigh Injection Clinic, the injection can sometimes be carried out on the same day as your assessment.
The Leigh Injection Clinic are based on the coast in Leigh on Sea, Essex – perfect for patients in Essex, Kent, London, and surrounding areas.
https://www.ultrasound-guided-injections.co.uk/bursitis-heel/
https://boneandjoint.org.uk/Article/10.1302/2046-3758.67.BJR-2016-0340.R1
https://www.webmd.com/pain-management/what-to-know-about-retrocalcaneal-bursitis