Infracalcaneal bursitis can significantly affect a person?s quality of life and his or her ability to perform activities of daily living, due to pain and impaired gait. This foot health problem may
be diagnosed in several ways, including by palpation, or light pressure applied to the affected area by a healthcare practitioner. If the heel pain has existed for a long time, X-ray imaging studies
may reveal localized calcification in the 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.
If the posterior-superior portion of the heel has an abnormally large bony prominence protruding from it (called a Haglund's Deformity), in some instances it may rub against the Achilles Tendon. When
this occurs, the bursa between the bone and the tendon will become inflamed, swollen, and painful. This condition is called Retrocalcaneal Bursitis. The presence of a Haglund's Deformity does not
insure that these problems will occur. In order for these problems to occur, the heel and foot must be tilted in such a way as to actually force this bony prominence into the bursa and tendon.
In retrocalcaneal bursitis, pain at the back of the heel is the main complaint from patients. Pain may worsen when tip-toeing, running uphill, jumping or hopping. Often, those who are accustomed to
wearing high-heeled shoes on a long-term basis may also complain of pain at the back of the heel when switching to flat shoes. This is because when in high-heeled shoes, the calf muscle and the
Achilles tendon are in a shortened position. Switching to flat shoes would cause an increased stretch to the calf muscle and Achilles tendon, irritating the Achilles tendon and the retrocalcaneal
bursa. Other symptoms may include redness and swelling at the back of the heel.
When you are experiencing Achilles pain at the back of your heel, a visit to the doctor is always recommended. Getting a proper diagnosis is important so you can treat your condition correctly. A
doctor visit is always recommended.
Non Surgical Treatment
One of the most effective treatments for infracalcaneal bursitis is to temporarily avoid weight-bearing activities that put stress or strain on your heel bone. PRICE (protection, rest, hot/cold
contrast compresses, compression, and elevation) is another good acute management technique for this foot problem. Changing your footwear is an effective long-term prevention and treatment tool for
infracalcaneal bursitis. Footwear that possess a flat support base, a sufficiently wide toe box to accommodate natural toe splay, and a flexible sole are best for preventing and managing
infracalcaneal bursitis. An integrated approach to this problem usually involves the use of padded socks that help reduce pressure, friction, and inflammation in your affected area. Natural
anti-inflammatory agents can also be helpful in quelling inflammation, reducing pain, and improving treatment times for infracalcaneal bursitis. In rare cases, more aggressive treatment methods may
be required, such as cortisone injections or surgery to drain the bursal sac.
Surgery to remove the damaged bursa may be performed in extreme cases. If the bursitis is caused by an infection, then additional treatment is needed. Septic bursitis is caused by the presence of a
pus-forming organism, usually staphylococcus aureus. This is confirmed by examining a sample of the fluid in the bursa and requires treatment with antibiotics taken by mouth, injected into a muscle
or into a vein (intravenously). The bursa will also need to be drained by needle two or three times over the first week of treatment. When a patient has such a serious infection, there may be
underlying causes. There could be undiscovered diabetes, or an inefficient immune system caused by human immunodeficiency virus infection (HIV).