Do you experience pain in your heel after a long day of work? Tenderness when pointing your feet or standing on your toes? Shoes feeling a bit tight and uncomfortable? You might be dealing with a case of heel bursitis. Heel bursitis, or inflammation of the fluid sacs (bursa) around the Achilles tendon, is a fairly common condition that generally affects athletes and those who work on their feet.
Anatomy Of The Foot
With two bursae located within the heel, the retrocalcaneal bursa located between the Achilles tendon and the calcaneus (heel bone) and the subcutaneous calcaneal bursa located between the Achilles tendon and the skin, there are a variety of factors that can cause an inflammation of these areas. Both of these are on the back of the heel. This is where most heel counters in shoes touch. Pressure from a shoe is a primary paint point for many.
Calcaneal Bursitis Causes
Causes vary by individual case, but bursitis of the heel often occurs amongst athletes due to repetitive training and trauma. In other cases, poorly fitting or tight shoes can cause unnecessary pressure around these areas of the heel. Those who are running, jumping, walking, or frequently standing might also suffer from this type of inflammation. Although somewhat uncommon, bursitis of the heel can also occur through a bacterial infection (septic bursitis in the heel), generally caused by bacteria entering through a cut or blister. This septic bursitis can make the skin at the back of the heel feel hot and can possibly cause a fever or chills in the patient. This bacterial infection, like most others, can be treated via oral antibiotics.
The most common cause by far is the same scourge that is responsible for most of our ailments; it is chronic low-grade inflammation. In addition, deposits of abnormal proteins at the tendon near its bony insertion site contribute to pain and bursal inflammation. These proteins are called advanced glycation end products and form when excess sugar comes in contact with the proteins found in tendons. Over time, the AGE deposition and the inflammation leads to a dysfunction, painful tendon with an inflamed bursa.
Treatments For Calcaneal Bursitis
Ice, Elevation, Rest and Stretching
Like many other orthopedic injuries, the easiest treatment and relief from this inflammation is ice and rest. Elevating and icing your foot can help lower inflammation, swelling and pain.
Additionally, performing gradual stretching of the Achillies tendon can help relieve the tension around this area of the heel and ankle.
Changing your Shoes
A change in shoes can sometimes relieve some of the unnecessary stress around your ankle and heel. If you normally wear high-heels, perhaps choose a more moderate-sized heel as switching to flats can often make the pain and inflammation worse. Long-term wear of higher heels can lead to contractures of the Achilles. Athletic shoes that are tight around the ankle can often be the cause of pain from this bursitis of the heel. Open-back shoes or shoes with a lower profile around the ankle can provide some additional relief. Simply reducing direct pressure on the bursa is a valid treatment option.
Medications like acetaminophen or the nonsteroidal anti-inflammatory drugs like ibuprofen can help alleviate pain and reduce inflammation. These come with a host of side effects however. Joint and muscle creams like our Foot Pain Relief Cream with Lidocaine, Menthol and PEA or our Pain Relief Cream with PEA, Menthol, and Turmeric can be useful in helping deal with the pain and inflammation. Topical remedies are often preferable to oral ones.
If the heel bursitis is not relieved by one of the above treatments, your doctor may choose to use a steroid injection to help relieve the inflammation. Dr. Warner believes that steroids too have a large group of side effects and should be used as a last resort only. There are many safer and more natural remedies available to try first.
In most cases, individuals dealing with heel bursitis will get better within a few weeks, however early diagnosis and treatment can help jumpstart the recovery process. If you feel like you might be suffering from heel bursitis, contact your healthcare provider or doctor.