Bursas are small fluid containing sacs, that are situated between areas of high friction such as bone against the floor (heel) and bone against other soft tissue structures like tendons, skin and or
muscle. The bursa job is to act as a shock absorber, and to allow stress free movement between the above noted structures. Bursitis is a swellinginflammation of the bursa sac, due to constant micro
trauma or overuse. In the foot Abnormal Pronation, most often caused by Morton?s Toe.
Bursitis occurs when the synovial lining becomes thickened and produces excessive fluid, leading to localized swelling and pain. It most commonly affects the subacromial, olecranon, trochanteric,
prepatellar, and infrapatellar bursae. Symptoms of bursitis may include localized tenderness, pain, edema, erythema, or reduced movement. Pain is aggravated by movement of the specific joint, tendon,
Symptoms of bursitis include pain in the heel, especially with walking, running, or when the area is touched. The skin over the back of the heel may be red and warm, and the pain may be worse with
attempted toe rise (standing on tippy-toes).
Plain radiographs of the calcaneus may reveal a Haglund deformity (increased prominence of the posterosuperior aspect of the calcaneus). However, on weight-bearing lateral radiographs, the
retrocalcaneal recess often appears normal even in patients with retrocalcaneal bursitis, limiting its usefulness in making this diagnosis.Radiographs may be used as a diagnostic measure to support a
clinician?s diagnosis of retrocalcaneal bursitis. Individuals with retrocalcaneal bursitis may have an absence of the normal radiolucency (ie, blunting) that is seen in the posteroinferior corner of
the Kager fat pad, known as the retrocalcaneal recess or bursal wedge. This may occur with or without an associated erosion of the calcaneus.
Non Surgical Treatment
Rest, ice, and anti-inflammatory medication will help with pain and swelling. Physical therapy can help stretch the Achilles to relieve any impingement. Also, a switch to properly-fitting shoes will
help to prevent the condition from worsening or recurring. You might also find relief with shoe inserts such as heel cups or padding. If you have tried these measures, yet symptoms remain severe and
continue to progress, surgical intervention is a possibility. Calcaneal bursitis surgery consists of excision or removal of the inflamed tissues and resection of the boney prominence. Debridement of
the affected area near the Achilles may also be performed, as well as repair of the Achilles if the condition has gone so far that the tendon ruptures.
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