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Overview<br>A bursa is a small sack of fluid that sits between a tendon and a bone to help the tendon move smoothly over the bone. The retrocalcaneal bursa in situated in the feet between the Achilles tendon and the calcaneus or heel bone. With repeated trauma the bursa can become inflamed. Achilles tendon bursitis is often mistaken for achilles tendinitis. It is possible for the athlete to have both achilles tendinitis and achilles tendon bursitis at the same time which is known as Haglund's syndrome.<br><br>Causes<br>Retrocalcaneal bursitis is generally caused by local trauma from poorly designed [http://sloppyrubbish2191.snack.ws/what-is-the-treatment-and-cause-for-adult-aquired-flatfoot.html shoes store]. Patients complain of posterolateral heel pain and may have a posterior heel prominence (?pump bump?), as well as local swelling and tenderness over the Achilles tendon. Pain is increased by squeezing the bursa from side to side and anterior to the Achilles. A heel lift and open-back shoes help alleviate pressure.<br><br>Symptoms<br>Bursitis usually causes a dull pain, tenderness, and stiffness near the affected bursa. The bursa may swell and make the skin around it red and warm to the touch. Bursitis is most common in the shoulder camera.gif, elbow camera.gif, hip camera.gif, and knee camera.gif. Bursitis may also occur near the Achilles tendon or in the foot. Symptoms of bursitis may be like those of tendinopathy. Both occur in the tissues in and around the joints. Check with your doctor if your pain is severe, if the sore area becomes very hot or red, or if you have a fever.<br><br>Diagnosis<br>Diagnosis of heel bursitis can be made by your health practitioner and is based on the following. Assessing the location of the pain by palpating the back of the heel. Assessment of any inflammation at the back of the heel. Assessment of biomechanics and foot function. Ultrasound or MRI can reveal inflammation of the retro calcaneal bursa.<br><br>Non Surgical Treatment<br>One of the most effective treatments for infracalcaneal bursitis is to temporarily avoid weight-bearing activities that put stress or strain on your heel bone. PRICE (protection, rest, hot/cold contrast compresses, compression, and elevation) is another good acute management technique for this foot problem. Changing your footwear is an effective long-term prevention and treatment tool for infracalcaneal bursitis. Footwear that possess a flat support base, a sufficiently wide toe box to accommodate natural toe splay, and a flexible sole are best for preventing and managing infracalcaneal bursitis. An integrated approach to this problem usually involves the use of padded socks that help reduce pressure, friction, and inflammation in your affected area. Natural anti-inflammatory agents can also be helpful in quelling inflammation, reducing pain, and improving treatment times for infracalcaneal bursitis. In rare cases, more aggressive treatment methods may be required, such as cortisone injections or surgery to drain the bursal sac.<br><br>Surgical Treatment<br>Bursectomy is a surgical procedure used to remove an inflamed or infected bursa, which is a fluid-filled sac that reduces friction between tissues of the body. Because retrocalcaneal bursitis can cause chronic inflammation, pain and discomfort, bursectomy may be used as a treatment for the condition when it is persistent and cannot be relived with other treatments. During this procedure, a surgeon makes small incisions so that a camera may be inserted into the joint. This camera is called an arthroscope. Another small incision is made so that surgical instruments can be inserted to remove the inflamed bursa.