Infracalcaneal bursitis can significantly affect your quality of life and your ability to perform your activities of daily living, due to pain and impaired gait. Inflammation of the bursal sac under
your heel bone occurs because the bursa is abnormally stressed or strained in some way or bears excessive pressure for prolonged periods. Constant pressure and friction from footwear is a common
cause of this health problem, and any treatment plan addressing infracalcaneal bursitis should include recommendations for footwear to avoid or use. Infracalcaneal bursitis may be diagnosed in
several ways, including palpation, or light pressure applied to your affected area. If your heel pain has existed for an extended period, X-ray imaging studies may reveal localized calcification in
your infracalcaneal bursa, though this is not always the case. MRI images are sometimes used as a diagnostic tool for this health problem, though MRI studies are considered unnecessary for diagnosis
in many cases.
Your ankle bursitis may have been caused by one or more of the following Pressure on your ankle and heels. This is often caused by running or exercising on uneven ground. The way that you exercise
may also cause ankle bursitis or make it worse. It may be caused by wearing poorly fitting shoes that constantly rub against the heel. Direct, hard hit to your heel. Infection (in-FEK-shun). Medical
problems such as rheumatoid (ROO-ma-toid) arthritis (ahr-THREYE-tis) or gout. Overusing your ankles. This is caused by doing activities or sports that use the same motions (movements) over and over
again. Examples of repeating motions are running, walking, or jumping. Sometimes people do not know how they developed ankle bursitis.
Pain at the back of the heel at the attachment site of the Achilles tendon when running. Pain on palpation of the back of the heel or bottom of heel. Pain when standing on tiptoes. Swelling and
redness at the back and bottom of the heel.
Diagnosis is first by clinical suspicion of symptoms. This can be mistaken for gout or infection especially in the big toe region. A diagnosis of bursitis is usually used in combination of the
underlying cause, for instance a bunion deformity, Haglund's deformity, or Heel Spur Syndrome. Many times the cause needs to be addressed to rid the problem of bursitis.
Non Surgical Treatment
If not properly treated, a case of bursitis can turn into chronic bursitis, flaring up on and off for several weeks or longer. Bursitis treatment involves resting the joint, often combined with other
methods to alleviate swelling, including NSAIDs (e.g. Aleve, ibuprofen), icing the joint, elevating the joint, and wrapping the joint in an elastic bandage. Cases of septic bursitis must also be
treated with antibiotics to prevent the infection from spreading to other parts of the body or into the bloodstream.
Surgery. Though rare, particularly challenging cases of retrocalcaneal bursitis might warrant a bursectomy, in which the troublesome bursa is removed from the back of the ankle. Surgery can be
effective, but operating on this boney area can cause complications, such as trouble with skin healing at the incision site. In addition to removing the bursa, a doctor may use the surgery to treat
another condition associated with the retrocalcaneal bursitis. For example, a surgeon may remove a sliver of bone from the back of the heel to alter foot mechanics and reduce future friction. Any
bone spurs located where the Achilles attaches to the heel may also be removed. Regardless of the conservative treatment that is provided, it is important to wait until all pain and swelling around
the back of the heel is gone before resuming activities. This may take several weeks. Once symptoms are gone, a patient may make a gradual return to his or her activity level before their bursitis
symptoms began. Returning to activities that cause friction or stress on the bursa before it is healed will likely cause bursitis symptoms to flare up again.
Because many soft tissue conditions are caused by overuse, the best treatment is prevention. It is important to avoid or modify the activities that cause problems. Underlying conditions such as leg
length differences, improper position or poor technique in sports or work must be corrected. Be aware of potential overuse or injury in your daily activities and change your lifestyle to prevent
problems. Otherwise, problems may persist or occur repeatedly. Following are some ways you can avoid future problems. Wear walking or jogging shoes that provide good support. High-top shoes provide
support for people with ankle problems. Wear comfortable shoes that fit properly. Wear heel cups or other shoe inserts as recommended by your doctor. Exercise on level, graded surfaces.