Between the heel bone and the plantar fascia is a small fluid filled sac that is called the plantar (bottom of) calcaneal (heel bone) bursa. The plantar calcaneal bursa?s job is to allow the plantar
fascia to glide easily over the heel bone without irritation. If this becomes inflamed and irritated a plantar calcaneal bursitis occurs which can be extremely painful and disabling forcing the
athlete to stop training.
Bursitis, tendinitis, and other soft tissue rheumatic syndromes typically result from one or more factors. These include: Play or work activities that cause overuse or injury to the joint areas
Incorrect posture Stress on the soft tissues from an abnormal or poorly positioned joint or bone (such as leg length differences or arthritis in a joint) Other diseases or conditions (rheumatoid
arthritis, gout, psoriasis, thyroid disease, or an unusual drug reaction) Infection.
A dull ache under the heel when not weight bearing. Sometimes severe pain when walking. Pain can increase after resting (sleeping or sitting) then standing and placing pressure on the area again.
Throbbing under the heel. Swelling may be identified as a discernible lump under the heel. This is the swollen calcaneal bursa itself. Tingling under the heel as swelling affect the plantar nerves.
Pains shooting into the foot or up the leg.
If heel pain has not responded to home treatment, X-rays may be ordered. These images can show deformities of the heel bone and bone spurs that have developed at the attachment of the Achilles. If
there is swelling and/or pain that is slightly higher and within the Achilles tendon itself, an MRI may be ordered to determine if the tendon is simply inflamed or if there is a chronic tear on the
tendon. Aspiration and lab tests. If a septic bursitis is highly suspected, a doctor may perform an aspiration, removing fluid from the bursa with a needle and syringe. In addition to relieving
pressure and making the patient more comfortable, it provides a fluid sample that can be tested for infection.
Non Surgical Treatment
Medications may be used to reduce the inflammation and pain of retrocalcaneal bursitis. Nonsteroidal anti-inflammatory drugs such as ibuprofen, naproxen and ketoprofen can be purchased without a
prescription and used to treat mild to moderate pain. These drugs are often used in combination with a physical therapy program or other retrocalcaneal bursitis treatments.
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