Heel bursitis is a fairly common condition that affects the area of the back of the heel, to which the Achilles tendon attaches, to become swollen and painful.
What is heel bursitis?
The ankle joint is made up of the two lower leg bones, the tibia and fibula, and the bones of the foot and ankle called the talus and the calcaneus respectively. These bones are held together within the ankle joint by tough tissues called ligaments.
Behind the ankle joint – between the Achilles tendon and the heel bone – is a small sac filled with fluid that cushions the anklebone, called a bursa. If this sac becomes inflamed, it causes the condition heel bursitis.
What are the symptoms of heel bursitis?
The main symptom of heel bursitis is a dull ache or pain around the heel area that develops over time. Other symptoms of heel bursitis include:
- Swelling above the bony part of the heel
- Warmth
- Tenderness
- An increase in pain if you press the area or flex or twist your foot or stand on your tiptoes
- Difficulty walking as you would do normally to help reduce the pain
What causes heel bursitis?
Heel bursitis can affect anyone but is more common in the over 40s. It can be caused by various different factors. However, there are certain factors that can mean you’re more at risk of developing heel bursitis:
- Repeatedly putting strain on the ankle such as through certain exercises including running, skiing and jumping or through your job
- Wearing ill-fitting or inappropriate shoes
- Running uphill often, without warming up first
- Experiencing impact, trauma or injury to the area
- Having an abnormality in the bones of the heel
- Having a medical condition such as gout or arthritis
How is heel bursitis diagnosed?
A doctor normally diagnoses heel bursitis after they’ve completed a physical examination of your ankle. They may need to move your ankle around gently to feel for sensitivity to movement, pain, swelling and warmth.
You may need an x-ray or MRI scan to get a definitive diagnosis and to rule out other possible ankle conditions, fractures or breaks.
How is heel bursitis treated?
Resting your foot and taking anti-inflammatory, over-the-counter painkillers such as ibuprofen can often manage heel bursitis. Your doctor may be able to prescribe you strong painkillers if necessary.
Wearing flat, comfortable shoes that give your feet room to move can also help, as can wearing heel supports in your shoes.
In more severe cases of heel bursitis, your doctor may be able to arrange physiotherapy and/or corticosteroid injections to help manage the pain.
Sometimes, the bursa is irritated by a bony spur at the back of the heel bone and will need to be removed by your surgeon.
If you’re unsure what treatment you should go for, or the above treatments don’t work for you, our team of expert specialists are here to help.