Retrocalcaneal bursitis is the inflammation of the fluid-filled sac (bursa) at the back of the heel bone (calcaneus). The retrocalcaneal bursa is located between the Achilles tendon and the heel bone
and is designed to reduce friction between the Achilles tendon and the heel bone. During contraction of the calf muscle, tension is generated through the Achilles tendon and it rubs against the
retrocalcaneal bursa. When there is excessive friction due to repetitive rubbing of the tendon against the bursa or high impact force translating through the Achilles tendon, irritation and
inflammation of the bursa may occur. The inflammation can also be aggravated by pressure, such as when athletes wear tight-fitting shoes. This condition is often mistaken for Achilles tendinitis but
it can also occur in conjunction with Achilles tendinitis.
A bursa acts as a cushion and lubricant between tendons or muscles sliding over bone. There are bursas around most large joints in the body, including the ankle. The retrocalcaneal bursa is located
in the back of the ankle by the heel. It is where the large Achilles tendon connects the calf muscles to the heel bone. Repeated or too much use of the ankle can cause this bursa to become irritated
and inflamed. Possible causes are too much walking, running, or jumping. This condition is usually linked to Achilles tendinitis. Sometimes retrocalcaneal bursitis may be mistaken for Achilles
tendinitis. Risks for this condition include starting an aggressive workout schedule, or suddenly increasing activity level without the right conditioning.
Common signs and symptoms associated with infracalcaneal bursitis include redness under the heel. Pain and swelling under the heel. Pain or ache in the middle part of the underside of the heel. Heel
pain or discomfort that increases with prolonged weight-bearing activities.
Gram stain. A lab test called a Gram stain is used to determine if certain troublesome bacteria are present. Not all bacteria can be identified with a Gram stain, however, so even if the test comes
back negative, septic bursitis cannot be completely ruled out. White blood cell count. An elevated number of white blood cells in the bursa's synovial fluid indicates an infection. Glucose levels
test. Glucose levels that are significantly lower than normal may indicate infection.
Non Surgical Treatment
Relieving the symptoms of bursitis initially focuses on taking the pressure off the bursa. This can be done with proper cushioning, inserts, or footwear but may require surgery if it is a bone
formation problem (i.e. Huglund's Deformity). If your bursitis is caused by an infection (septic bursitis), the doctor will probably drain the bursa sac with a needle and prescribe antibiotics to
treat the infection.
Surgery is rarely need to treat most of these conditions. A patient with a soft tissue rheumatic syndrome may need surgery, however, if problems persist and other treatment methods do not help