Retrocalcaneal bursitis Health Article

Definition

Retrocalcaneal bursitis is swelling (inflammation) of the fluid-filled sac (bursa) at the back of the heel bone (calcaneus).

Alternative Names

Insertional heel pain

Causes, incidence, and risk factors

A bursa acts as a cushion and lubricant between tendons and muscles sliding over bone. There are bursas around most large joints in the body, including the ankle.

The retrocalcaneal bursa is located in the back of the ankle by the heel. It is where the large Achilles tendon connects the calf muscles to the heel bone.

Repeated or too much use of the ankle can cause this bursa to become irritated and inflamed. Possible causes are excessive walking, running, or jumping.

This condition is commonly associated with Achilles tendonitis. Sometimes retrocalcaneal bursitis may be mistaken for Achilles tendonitis.

Those at risk for this condition include people just starting aggressive exercise regimens or who suddenly increase their activity without proper conditioning.

Symptoms

• Pain in the heel, especially with walking, running, or when the area is touched
• Pain may get worse when rising on the toes (standing on tiptoes)
• Red, warm skin over the back of the heel

Signs and tests

Your health care provider will take a history to find out if you have symptoms of retrocalcaneal bursitis. Examining your ankle can find the location of the pain. The physician will look for tenderness and redness in the back of the heel.

The pain may be worse when the doctor bends the ankle upward (dorsiflex). Or, the pain may be worse when you rise on your toes.

Imaging studies such as x-ray and MRI are not usually necessary at first. If the first treatment fails to improve the symptoms, your health care provider may recommend these studies. MRI may show inflammation.