Bursae are small, fluid-filled sacs that protect tendons and bones. Heel bursitis is the inflammation of the bursae that cushion the back of the heel.

Heel bursitis often resolves on its own, although doctors may recommend treatment to manage pain. Doctors sometimes refer to heel bursitis as retrocalcaneal bursitis.

This article outlines the symptoms, causes, and risk factors for heel bursitis. It also looks at prevention methods and treatment options.

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Bursitis can be acute or chronic. When it is acute, bursitis can present with the following symptoms:

  • pain in the bursae, which may worsen with some movements
  • swelling of the bursae

In contrast, chronic bursitis often does not cause any pain. However, it can cause the following symptoms:

  • significant swelling and thickening of the bursae
  • unusually warm bursae
  • inflamed skin near the affected bursae

These symptoms will be prominent on or near the heel in heel bursitis.

There are several possible causes of heel bursitis. These include:

  • prolonged pressure on the bursae
  • repetitive motion
  • trauma
  • rheumatoid arthritis
  • osteoarthritis
  • gout
  • systemic lupus erythematosus, which is an autoimmune condition that can cause problems with multiple organs
  • scleroderma, which is an autoimmune condition that causes collagen to build up

Heel bursitis can also develop without any obvious cause.

Heel bursitis may be more likely to develop in:

  • older adults
  • those who have obesity
  • those who work in jobs that require manual labor, such as gardeners, mechanics, and plumbers

Septic bursitis is a form of bursitis in which an infection also affects the bursae. Septic bursitis may be more likely to develop in people with compromised immune systems, such as those with:

  • diabetes
  • alcohol use disorder
  • HIV
  • arthritis

Doctors can diagnose heel bursitis based on a person’s symptoms. However, they may sometimes rely on other medical tests to assist in their diagnosis, such as:

  • Imaging tests: These tests can determine the extent and cause of bursitis. For instance, imaging tests can find evidence of trauma, which can lead to bursitis.
  • Aspiration and testing of the bursae fluid: Doctors can use a needle and syringe to acquire some fluid from the inflamed bursae. They can then test this fluid for signs of septic bursitis. Tests may also reveal the presence of tiny crystals, which might signify a disease like gout.

Most cases of bursitis resolve without treatment. To manage pain from heel bursitis and increase the speed of recovery, individuals can try the following:

  • resting the heel
  • using ice or cold compresses on the heel
  • elevating the heel
  • using footwear that reduces pressure on the heel area
  • taking pain medications, such as acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs)

In more serious cases of heel bursitis, doctors may recommend other forms of treatment or management. For instance, a 2021 study suggests that in 63% of people, corticosteroid injections can cause significant short-term reductions in pain from heel bursitis.

A different 2021 study investigated the effects of surgery on heel bursitis. The study examined how the surgery affected important factors such as pain, structural changes, and range of motion. Significant improvements in these areas were still present 1 year after surgery.

Exercises

Physical therapy exercises may help with recovery in people with chronic heel bursitis. The theory is that these exercises can strengthen the muscles around the bursae, which puts less strain on the bursae.

A physical therapist can advise on which exercises to try and how to perform them safely.

By avoiding some causes and risk factors of heel bursitis, individuals might be able to prevent its development. The following tips may have this effect, although there is no direct evidence of their efficacy:

  • achieving and maintaining a healthy BMI, if applicable
  • wearing footwear that puts little pressure on the heel
  • avoiding trauma to the heel area
  • avoiding repetitive heel motions

If a person develops symptoms of heel bursitis, it is best to speak with a doctor. A doctor can advise a person on how to lessen any pain or discomfort and suggest treatment options.

Most people with bursitis have a good outlook. However, bursitis can reoccur in those who are unable to avoid the trigger of heel bursitis.

According to a 2023 overview of existing research, septic bursitis can lead to some complications. These include ruptured bursae and wound-healing problems. Septic bursitis can also cause osteomyelitis, an infection of the bone marrow.

Plantar fasciitis is inflammation at the bottom of the foot, around the heel and arch of the foot. More specifically, plantar fasciitis affects the plantar fascia, a part of the foot that connects the toes to the heel bone.

A 2022 article explains that plantar fasciitis is often an overuse injury. Unlike bursitis, it is not a condition that affects the bursae. However, heel bursitis and plantar fasciitis can cause similar kinds of pain.

Bursae are small sacs of fluid that act as protective cushions for bones and tendons. Bursitis refers to inflammation of the bursae. When it affects the bursae that protect the heel, this is heel bursitis.

Acute heel bursitis can be painful and cause swelling around the heel. Pain is less common in chronic heel bursitis, although significant swelling can arise. Chronic heel bursitis may also lead to skin inflammation and warmth around the heel.

Doctors can diagnose bursitis based on a person’s symptoms, although further tests may sometimes be necessary. Bursitis often resolves on its own.

Painkillers, rest, and ice can help to manage heel bursitis while it heals. However, some people with heel bursitis may require more involved forms of treatment, such as steroid injections or surgery.