There is a thick walled fluid filled bursa between the Achilles tendon and the calcaneal bone. The color Doppler images show hypervascularity of the bursal wall. A minimal amount of fluid in the
retrocalcaneal bursa can often be found. A retrocalcaneal bursitis is caused by friction of the Achilles tendon over the upper part of the calcaneal bone. It is often an overuse injury found in
Inflammation of the bursa causes synovial cells to multiply and thereby increases collagen formation and fluid production. A more permeable capillary membrane allows entrance of high protein fluid.
The bursal lining may be replaced by granulation tissue followed by fibrous tissue. The bursa becomes filled with fluid, which is often rich in fibrin, and the fluid can become hemorrhagic. One study
suggests that this process may be mediated by cytokines, metalloproteases, and cyclooxygenases.
Nagging ache and swelling in or around a joint. Painful and restricted movement in the affected joint. Pain radiating into the neck or arms when bursitis strikes the shoulder (the most common site).
Fever, when associated with an infection.
Your doctor will examine you, including an evaluation of your gait, while you are barefoot, your doctor will ask you to stand still and to walk in order to evaluate how your foot moves as you walk.
An examination of your feet. Your doctor may compare your feet for any differences between them. Then your doctor may examine your painful foot for signs of tenderness, swelling, discoloration,
muscle weakness and decreased range of motion. A neurological examination. The nerves and muscles may be evaluated by checking strength, sensation and reflexes. In addition to examining you, your
health care professional may want to examine your shoes. Signs of excessive wear in certain parts of a shoe can provide valuable clues to problems in the way you walk and poor bone alignment.
Depending on the results of your physical examination, you may need foot X-rays or other diagnostic tests.
Non Surgical Treatment
According to the National Institutes of Health, custom heel wedges can be purchased by people suffering from retrocalcaneal bursitis. These wedges reduce stress on the heel, which can reduce the pain
and inflammation associated with an inflamed bursa. They can be purchased without a prescription, making it easy for anyone experiencing a flare-up of symptoms to get the added support of these
You can help to prevent heel pain and bursitis by maintaining a healthy weight, by warming up before participating in sports and by wearing shoes that support the arch of the foot and cushion the
heel. If you are prone to plantar fasciitis, exercises that stretch the Achilles tendon (heel cord) and plantar fascia may help to prevent the area from being injured again. You also can massage the
soles of your feet with ice after stressful athletic activities. Sometimes, the only interventions needed are a brief period of rest and new walking or running shoes.