The inflammation of the Achilles bursa is not to be confused with the, more common, retrocalcaneal bursitis. Although the retro-calcaneal and Achilles bursae are in the similar region of the heel and
their irritation gets treated in almost an identical way, they are two different things.
Posterior heel pain can come from one of several causes. When a physician is talking about posterior heel pain, he or she is referring to pain behind the heel, not below it. Pain underneath the heel,
on the bottom of the foot, has several causes including Tarsal Tunnel Syndrome. Plantar Fasciitis. Heel Spurs.
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.
After you have described your foot symptoms, your doctor will want to know more details about your pain, your medical history and lifestyle, including whether your pain is worse at specific times of
the day or after specific activities. Any recent injury to the area. Your medical and orthopedic history, especially any history of diabetes, arthritis or injury to your foot or leg. Your age and
occupation. Your recreational activities, including sports and exercise programs. The type of shoes you usually wear, how well they fit, and how frequently you buy a new pair.
Non Surgical Treatment
In addition to being aware of foot-wear and inserts, be sure to modify your activity level to reduce the pain initially. Taking non-steroidal anti-inflammatory drugs (NSAIDs) and icing twice a day
for 20 minute periods can help reduce the swell that leads to heel pain. Cortisone injections (more powerful anti-inflammatory medications) can be considered if your symptoms are persistent. After
the swelling and pain has receded, ask your podiatrist about working with a physical therapist to strengthen the affected area in order to avoid bursitis by using your muscles in a more safe and
efficient manner. If all these treatment methods fail, surgery may be the best option to excise a painful bursa (note that this is in rare cases).
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
Because many soft tissue conditions are caused by overuse, the best treatment is prevention. It is important to avoid or modify the activities that cause problems. Underlying conditions such as leg
length differences, improper position or poor technique in sports or work must be corrected. Be aware of potential overuse or injury in your daily activities and change your lifestyle to prevent
problems. Otherwise, problems may persist or occur repeatedly. Following are some ways you can avoid future problems. Wear walking or jogging shoes that provide good support. High-top shoes provide
support for people with ankle problems. Wear comfortable shoes that fit properly. Wear heel cups or other shoe inserts as recommended by your doctor. Exercise on level, graded surfaces.