Heel pain can also be caused due a condition called Bursitis which is constant irritation of the heel's natural cushion (bursa). This can lead to additional pain at the back of the heel when the
ankle is moved and there may be swelling on both sides of the Achilles tendon. Useful treatments for Heel bursitis are anti-inflammatory medications such as aspirin and Ibuprofen gel/tablets. Cold
ice-pack compresses can be useful in reducing any swelling. In conjunction to these treatments it is important to stabalise and protect the heel. Gel heel pads will help to let the inflamed bursa
settle down, however in severe chronic cases sometimes the use of Cortisone injections may be indicated.
The following are some of the more common causes for heel bursitis. Overuse (common in runners and athletes). Running with the wrong footwear. A sudden impact to the foot. Repetitive stress.
Underlying inflammatory condition (such as osteoarthritis).
Limping. Decreased movement. Your ankles may feel stiff or unable to move as well as they usually do. Pain or tenderness in the back of the ankle. It may be worse at the beginning of exercise, or
when running uphill. You may also have pain when wearing shoes. Redness and warmth. If the bursa is infected, the skin over the heel may be red and warm. You may also have a fever. Swelling on the
back of the heel.
Carrying out a diagnosis for bursitis is fairly straightforward. The doctor will examine the affected area and ask the patient some questions about his/her recent activities. If the patient has a
high temperature the physician may take a small sample of fluid from a bursa near the affected body part. The sample will be tested for bacteria, and perhaps also crystals. If the patient does not
get better after treatment the doctor may carry out further tests so that he/she can eliminate the possibility that the symptoms might not be due to something else. These may include an x-ray, to
make sure no bones are broken or fractured. Blood tests, to check for rheumatoid arthritis. A CT scan or MRI scan to see if there is a torn tendon.
Non Surgical Treatment
The patient with retrocalcaneal bursitis should be instructed to apply ice to the posterior heel and ankle in the acute period of the bursitis. Icing can be performed several times a day, for 15-20
minutes each. Some clinicians also advocate the use of contrast baths. Gradual progressive stretching of the Achilles tendon may help relieve impingement on the subtendinous bursa and can be
performed in the following manner. Stand in front of a wall, with the affected foot flat on the floor. Lean forward toward the wall until a gentle stretching is felt within the ipsilateral Achilles
tendon. Maintain the stretch for 20-60 seconds and then relax. Perform the stretches with the knee extended and then again with the knee flexed. To maximize the benefit of the stretching program,
repeat the above steps for several stretches per set, several times daily. Avoid ballistic (ie, abrupt, jerking) stretches. Other treatment options are microcurrent therapy and corticosteriod
injection into the retrocalcaneal bursa. If conservation treatment fails then surgery is indicated.
Surgery is rarely need to treat most of these conditions. A patient with a soft tissue rheumatic syndrome may need surgery, however, if problems persist and other treatment methods do not help
It isn't always possible to avoid the sudden blow, bump, or fall that may produce bursitis. But you can protect your body with measures similar to those that protect you from other kinds of overuse
injuries, such as tendinitis. Keep yourself in good shape. Strengthening and flexibility exercises tone muscles that support joints and help increase joint mobility. Don?t push yourself too hard (or
too long). If you?re engaged in physical labor, pace yourself and take frequent breaks. If you?re beginning a new exercise program or a new sport, work up gradually to higher levels of fitness. And
anytime you?re in pain, stop. Work on technique. Make sure your technique is correct if you play tennis, golf, or any sport that may strain your shoulder. Watch out for ?elbow-itis.? If you
habitually lean on your elbow at your work desk, this may be a sign that your chair is uncomfortable or the wrong height. Try to arrange your work space so that you don?t have to lean on your elbow
to read, write, or view your computer screen. Take knee precautions. If you have a task that calls for lots of kneeling (for example, refinishing or waxing a floor), cushion your knees, change
position frequently, and take breaks. Wear the right shoes. High-heeled or ill-fitting shoes cause bunions, and tight shoes can also cause bursitis in the heel. Problems in the feet can also affect
the hips. In particular, the tendons and bursae in the hips can be put under excessive strain by worn-down heels. Buy shoes that fit and keep them in good repair. Never wear a shoe that?s too short
or narrow. Women should save their high heels for special occasions only. Avoid staying in only one position for too long. Get up and walk around for a while or change positions frequently.