A bursa is a fluid-containing sac that is present at many areas of pressure on the body. Its job is to protect these areas of pressure by being a shock absorber. A bursitis is an abnormal
inflammation of the bursa sac caused by abnormal excessive pressure, stress and/ or strain over the area it is protecting. On the heel bone, there are two bursa sacs: one on the bottom and the other
on the back. Specifically on the bottom of the heel, it is known as an Inferior (bottom) Calcaneal (heel) Bursa. On the back of the heel, it is called the Retro (back) Calcaneal Bursa. When either of
these bursas become abnormally stressed, strained, or swollen, the result is bursitis of the heel. It is this bursitis that is the reason for pain in the heel upon arising (Poststatic Dyskinesia) in
the morning or after resting for a while. You can either develop these bursitises with or without the presence of heel spur (explanation to follow). As stated before, Morton?s Toe can cause this by
causing over pronation in the foot.
Causes of bursitis can be from any form of friction between bone and the soft tissues. The most common cause is due to abnormal pronation.
You might have Retrocalcaneal Bursitis if you notice any of the following symptoms. You have pain or tenderness at the back of the heel where the Achille's tendon attaches. Have swelling near the
attachment of the tendon to the heel bone. You have noticed a slowly growing bump on the back of the heel. The back of the heel turns red after getting rubbed in shoes. The back of the heel hurts
worse when you run, walk up hill or wear high heels.
When a patient has pain in a joint, a careful physical examination is needed to determine what type of movement is affected and if there is any swelling present. Bursitis will not show up on x-rays,
although sometimes there are also calcium deposits in the joint that can be seen. Inserting a thin needle into the affected bursa and removing (aspirating) some of the synovial fluid for examination
can confirm the diagnosis. In most cases, the fluid will not be clear. It can be tested for the presence of microorganisms, which would indicate an infection, and crystals, which could indicate gout.
In instances where the diagnosis is difficult, a local anesthetic (a drug that numbs the area) is injected into the painful spot. If the discomfort stops temporarily, then bursitis is probably the
Non Surgical Treatment
Treatment for soft tissue conditions focuses on reducing pain and inflammation, and on preserving mobility and preventing disability and recurrence. The treatment for many soft tissue conditions is
similar. A doctor's recommendations may include a combination of rest, splints, heat and cold application, medications, physical therapy, or occupational therapy. A person with a soft tissue
condition may try several treatments before he or she finds the best one for his or her specific condition.
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