Do you experience pain at the back of your heel? Is the back of your heel red and swollen? And you were told that it might Achilles Tendonitis? But so far treatment for Achilles Tendonitis does not seem to be working? You might be suffering instead from Retrocalcaneal Bursitis.
The causes and risk factors of retrocalcaneal bursitis are listed below. Identifying the underlying reason the bursa is inflamed will help set a course for treatment. Repetitive use of the ankle. Retrocalcaneal bursitis is often caused by frequent "mini-traumas." These mini-traumas are often due to excessive walking, jumping, or running. Running uphill, which causes the foot to flex considerably, can be especially irritating to the retrocalcaneal bursae. People who suddenly intensify their exercise programs without adequate stretching and muscle conditioning may get retrocalcaneal bursitis. In general, it is often associated with over use of the Achilles attachment, the area where the Achilles tendon fibers attach to the heel.
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.
Like all other forms of bursitis, initially the physician will take down the history of symptoms experienced by the patient, this will be followed by a detailed physical examination which involves checking for inflammation signs like pain, redness, and warmth of the heel area. The physician might examine further by moving the ankle a little to determine the exact location of pain. Further diagnostic tests including x-ray, bone scans, and MRI scan might be suggested if required.
Non Surgical Treatment
Podiatric Care may include using anti-inflammatory oral medications or an injection of medication and local anesthetic to reduce the swelling in the bursa. An injection may be used for both diagnosis and for treatment. When you go to your doctor, x-rays are usually required to evaluate the structure of your foot and ankle to ensure no other problems exist in this area. They may advise you on different shoewear or prescribe a custom made orthotic to try and control the foot structure especially if you have excessive pronation. Sometimes patients are sent to Physical Therapy for treatment as well. To aid in relief of pressure points, some simple padding techniques can be utilized. Most all patients respond to these conservative measures once the area of irritation is removed.
Surgery to remove the damaged bursa may be performed in extreme cases. If the bursitis is caused by an infection, then additional treatment is needed. Septic bursitis is caused by the presence of a pus-forming organism, usually staphylococcus aureus. This is confirmed by examining a sample of the fluid in the bursa and requires treatment with antibiotics taken by mouth, injected into a muscle or into a vein (intravenously). The bursa will also need to be drained by needle two or three times over the first week of treatment. When a patient has such a serious infection, there may be underlying causes. There could be undiscovered diabetes, or an inefficient immune system caused by human immunodeficiency virus infection (HIV).