If you have pain in the back of your heel that worsens during activities like walking and running, you may have bursitis of the heel. Caused by swelling of the bursae, small fluid-filled sacs located at the end of the heel bone, bursitis has a variety of treatments once it's diagnosed.
What Is Bursitis of the Heel?
Bursitis of the heel causes pain as the fluid-filled bursa swells. Bursae are located at most large body joints and help keep the joints cushioned and lubricated between bones and tendons or muscles. Heel problems stem from the retrocalcaneal bursa located at the Achilles tendon that connects the heel bone to the calf muscles. This spot at the back of the ankle can become irritated and swollen.
Bursitis can affect many major joints, often the shoulder, hip, and elbow. It may also occur in knee joints and the base of the big toe. All types of bursitis are caused by overuse or repetitive motion. They often heal over a few weeks but are subject to flare-ups.
Heel Bursitis Causes
Bursitis of the heel can be caused by overuse of the joint. For the heel area, excessive running, walking, and jumping can cause bursitis. Sudden increases in activity without proper preparation can cause bursitis of the heel and issues with arthritis caused by inflammation of the joints. Running on hard surfaces like concrete and inflammation of the Achilles tendon can cause bursitis. It's also possible to get bursitis from shoes that don't fit properly or from mishaps where you land on your heel or movements that cause sudden outward or inward turning of your foot.
What Does Bursitis Pain Feel Like?
Heel bursitis causes pain in the back of the heel that worsens during activity, with an achy or stiff feeling that hurts more when pressure is applied. Standing on your tiptoes will cause even more pain since this movement causes more pressure to the area. The skin may get warm to the touch or take on a reddish tone with the symptoms. Pain can get to the point where it limits daily activities or even becomes disabling. Severe pain requires prompt medical attention, while more minor symptoms can be tackled initially with home remedies.
Bursitis of the heel can also be confused with Achilles tendinitis, a related condition in the same area. Inflammation occurs in the tendon connecting the back of your leg to the back of your heel. Since this tendon pushes your foot down, it causes pain similar to bursitis of the heel when walking, jumping, running, and other activities. Bursitis is also related to bone spurs in the heel, bony growths from calcium deposits from the body's response to repetitive stress on the heel. Another related condition that causes heel pain, plantar fasciitis, is the swelling of the band of ligament tissue on the bottom of the foot that connects the heel bone to the toes.
How Is Heel Pain Treated?
Heel pain can be initially treated at home if the symptoms aren't severe and subside within a couple of weeks. The first remedy is to let the area heal by limiting pressure and resting for a week. Home remedies include icing the affected area a couple of times a day for about 10 to 15 minutes to reduce swelling, taking over-the-counter pain relievers like acetaminophen or ibuprofen, and using special shoe accessories like inserts, heel cups, and pads.
If home treatments don't improve symptoms in a couple of weeks, or if the pain becomes severe with a quick onset, contact a doctor. Other symptoms that warrant a call to the doctor include increasing redness and swelling or the inability to put pressure on your foot. Shooting pain, inability to move the joint, and fevers are other signals to see a doctor as soon as possible.
Treatment includes physical therapy and special exercises that help the foot heal and build up strength. Physical therapy may also include ultrasound treatment targeted at reducing inflammation. Exercise is also a good preventative measure for heel issues, as strong muscles and flexibility in the calves, ankles, and feet build up resistance to injury. Wearing proper shoes also helps encourage healing and the prevention of heel problems. Warming up and stretching before exercise can help build strength and make joints more flexible as well.
Doctors likely may have an X-ray or MRI done to check for the cause of the pain if regular treatments aren't effective. Steroid injections into the bursa may also alleviate symptoms. For heel bursitis sufferers who also have Achilles tendinitis, doctors may want to have the ankle in a cast for a number of weeks. The conditions rarely require surgery, but it can be done to remedy the inflamed bursa in certain instances.
Are There Risk Factors?
Bursitis is a condition that anyone can have, but age, activities, and medical conditions can increase the risk of developing it. The chances of developing bursitis increase with age. Activities or jobs with repetitive motions or that require applying pressure to bursae increase the risk. Factory jobs that require repetitive motion and walking on hard floors can be a risk factor. Running uphill or other intensive exercises that are ramped up too fast increases risk. People with medical conditions like rheumatoid arthritis, diabetes, and gout are at higher risk.
Previous injuries also increase the risk of developing bursitis and other joint problems. Foot or ankle bone abnormalities and deformities cause extra friction and lead to bursitis.
If you have symptoms that don't improve within a couple of weeks after beginning rest and home remedies, or if symptoms get worse quickly, have your foot checked out by a specialist. Dr. Schoene at Gurnee Podiatry and Sports Medicine Associates can help you explore treatment options. A specialist will find the best way for you to get back on your feet and prevent future bursitis flare-ups. For information on heel bursitis and other podiatric conditions we treat, contact us by calling our Chicago office at 312-642-6020 or our Park City office at 847-263-6073.