Heel bursitis

At the attachment of the Achilles tendon to the heel bone there are two bursae. A deeper one, located between the heel bone and the Achilles tendon, and a more superficial one between the Achilles tendon and the skin. A bursitis of the heel is an inflammation of one of these two bursae.

A bursa is a small sac filled with joint fluid that ensures that different structures such as tendons, bone and skin can move over each other smoothly.

The superficial bursa of the heel, called the bursa subcutanea calcanea, is located between the Achilles tendon and the skin. The deeper bursa of the heel, called the bursa retrocalcanea, lies between the Achilles tendon and the heel bone.

How does a bursitis of the heel arise?

A bursitis of the heel will in most cases develop gradually. In the superficial bursa an inflammation is often the result of local damage or trauma to the bursa. A good example is rubbing of the shoe edge against the heel; with repeated rubbing the bursa can become irritated. Inflammation of the deeper bursa is often seen after or during Achilles tendonitis. Due to swelling of the Achilles tendon, the bursa is compressed.

Symptoms are most often seen in the 40-60 age group and very frequently in people who run or do sports with a lot of jumping.

Symptoms of a bursitis of the heel

In a bursitis of the heel, signs such as swelling, warmth, redness, (pressure) pain and restricted movement occur.

In a superficial bursitis, a red lump may be visible at the attachment of the Achilles tendon to the heel bone. This lump can be painful. Wearing closed shoes can also be painful.

In the deep bursa, in the case of inflammation, the pain can vary. The pain can be felt on the left and right along the Achilles tendon and mainly appears after a day of hard work or sport.

How is the diagnosis of a bursitis of the heel made?

A bursitis of the heel is generally well diagnosed by a GP or physiotherapist. Additional tests, such as ultrasound, CT scan or MRI scan, will only be needed in a few cases to make the diagnosis.

How is a bursitis of the heel treated?

It is important to start treatment in time, preferably under the guidance of a physiotherapist. First, treatment will focus on reducing pain. Graded rest and icing of the painful spot are very important here.

In the next step of the treatment process, attention will be focused on increasing the load capacity. Possible interventions used by the physiotherapist are massage, stretching, exercise therapy and joint mobilisations.

The prognosis (expectation of recovery) of a bursitis of the heel is generally very good. People are often able to resume their normal activities within a few weeks.