Retrocalcaneal bursitis is sometimes difficult to differentiate from Achilles tendinitis, at least symptomatically. Both are most uncomfortable during the push-off phase of gait, are most severely painful in the morning and with walking after sitting for a period of time, and generally worsen with activity. Most practitioners make the distinction between the two simply on the basis of location of pain and tenderness. Generally, Achilles tendinitis is felt an inch or two higher than this form of bursitis.
Wearing poorly fitting or constrictive footwear can cause the heel to become irritated and inflamed. Shoes that dig into the back of the heel are the primary cause of retroachilles bursitis. Foot or ankle deformity. A foot or ankle deformity can make it more likely to develop retrocalcaneal bursitis. For example, some people can have an abnormal, prominent shape of the top of their heel, known as a Haglund's deformity. This condition increases the chances of irritating the bursa. A trauma to the affected heel, such as inadvertently striking the back of the heel against a hard object, can cause the bursa to fill with fluid, which in turn can irritate and inflame the bursa's synovial membrane. Even though the body usually reabsorbs the fluid, the membrane may stay inflamed, causing bursitis symptoms.
Achiness or stiffness in the affected joint. Worse pain when you press on or move the joint. A joint that looks red and swollen (especially when the bursae in the knee or elbow are affected). A joint that feels warm to the touch, compared to the unaffected joint, which could be a sign that you have an infection in the bursa. A ?squishy? feeling when you touch the affected part. Symptoms that rapidly reappear after an injury or sharp blow to the affected area.
Your GP or therapist will be able to diagnose you by both listening to your history and examining you. No X-rays or further investigation should be needed to confirm diagnosis but may be requested to check for any underlying health conditions that may have triggered the bursitis.
Non Surgical Treatment
If you follow these steps, most attacks of bursitis should subside in four or five days and all symptoms should be gone within two weeks. Rest the body part that hurts. If you suspect that one activity has caused the pain, stop it until the pain is entirely gone. A sling, splint, or padding may be needed to protect the area from possible bumps or irritation. Try over-the-counter pain relievers. Nonprescription NSAIDs (aspirin, ibuprofen, and naproxen) will help reduce pain and swelling, though they won?t accelerate healing. Acetaminophen will help with pain but it doesn?t reduce inflammation. Ice it, then heat it. Apply ice packs during the first two days to bring down swelling. Then use heat-warm baths or a heating pad (on a medium or low setting)-to ease pain and stimulate blood flow. Don?t push it. Resume exercising only after you feel better. Start with gentle activity. Skip the liniments. Liniments and balms are no help for bursitis. Liniments don?t penetrate deeply enough to treat bursitis, they mainly warm the skin and make it tingle, thus distracting attention from the pain beneath. Massage is likely to make matters worse. Undergo physical therapy. Physical therapy strengthens joint muscles that have been affected by bursitis and may help prevent the bursitis from getting worse.
Once your pain and inflammation is gone, you can prevent retrocalcaneal bursitis deformity by wearing the best shoes for your foot type. You should high-heels and pumps if possible. Wear orthotics (custom arch supports) or over-the-counter orthotic devices. Perform frequent Achilles tendon stretching exercises to prevent it from becoming tight agian. Avoiding running uphill when training. Try to run on softer surfaces and avoid concrete.