Bursitis and tendinitis are conditions that are also known as soft tissue rheumatic syndromes. A syndrome is a group of signs and symptoms that occur together and indicate a particular problem. This
type of syndrome produces pain, swelling, or inflammation in the tissues and structures around a joint, such as the tendons, ligaments, bursae, and muscles.
Repetitive, vigorous movement, strenuous and unaccustomed activities that put pressure on a joint, or a blow or other injury can bring on bursitis. The cause can vary depending on where the bursitis
occurs. In the shoulder, for example, it can be brought on by excessive strain, such as from serving in tennis. Kneeling on a hard floor can cause bursitis of the knee, and similarly, repeatedly
resting the elbow on a hard surface (such as a desk) can cause bursitis in that joint. Arthritis, gout, and certain infections can also contribute to the problem. Bursitis, in fact, may signal the
onset of arthritis. While getting older isn't a cause of bursitis, older people, especially older athletes, are more likely to develop the condition.
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.
When you suspect you have retrocalcaneal bursitis, your foot doctor will begin by taking a complete history of the condition. A physical exam will also be performed. X-rays are usually taken on the
first visit as well to determine the shape of the heel bone, joint alignment in the rearfoot, and to look for calcium deposits in the Achilles tendon. The history, exam and x-rays may sufficient for
your foot surgeon to get an idea of the treatment that will be required. In some cases, it may be necessary to get an ultrasound or MRI to further evaluate the Achilles tendon or its associated
bursa. While calcium deposits can show up on xray, the inflammation in the tendon and bursa will show up much better on ultrasound and MRI. The results of these tests can usually be explained on the
first visit. You can then have a full understanding of how the problem started, what you can do to treat prevent it from getting worse/ You will also know which treatment will be most helpful in
making your heel pain go away.
Non Surgical Treatment
Many cases of retrocalcaneal and retroachilles bursitis can be treated effectively at home. One of the most important factors is eliminating shoe gear that presses against the back of the heel.
Comfortable, supportive footwear and frequently resting the foot will minimize friction at the heel and give the inflammation a chance to subside. These steps, along with other methods to alleviate
swelling, such as non-steroidal anti-inflammatory drugs (NSAIDs, e.g., ibuprofen), icing the heel, and elevating the foot, are usually successful in treating retrocalcaneal bursitis.
Surgery is rarely done strictly for treatment of a bursitis. If any underlying cause is the reason, this may be addressed surgically. During surgery for other conditions, a bursa may be seen and