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.
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
- 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
- prolonged pressure on the bursae
- repetitive motion
- rheumatoid arthritis
- 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
- 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:
- alcohol use disorder
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.
- 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.
Physical therapy exercises
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.
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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.
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.