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Overview<br>Retrocalcaneal Bursitis. This bursa is located at the back of the heel. Bursitis in this area is often associated with conditions such as ankylosing spondylitis or rheumatoid arthritis. It can occur in healthy individuals who wear improperly fitted shoes. Symptoms include painful swelling that develops at the back of the heel. Calcaneal Bursitis. This bursa is located at the sole or bottom of the heel. Inflammation usually produces pain in the heel when standing. Causes include [http://rodgersslldxqacxw.exteen.com/20150627/hammertoe-correction heel spurs], excess weight, injury, and wearing improperly fitted shoes.<br><br>Causes<br>For the most part, it is a genetic condition.  You develop it by inheriting a foot type that is prone to the mechanical irritation that leads to the problem.  If you have this particular foot type and wear shoes that rub and irritate the back of the heel bone (calcaneus) where the Achilles tendon attaches, then you are even more likely to develop this type of bursitis. The contributing factors include a supinated foot type, a heel bone with a prominence (or pointed shape that stick out toward the tendon) at the back, a tight Achilles tendon (referred to as Equinus by doctors), and a high arch. All of these factors simply make it more likely that the back of the heel will press against the shoe and rub. As the tendon gets rubbed the wrong way, the bursa starts to develop and fill with fluid. This response is really your body's way of protecting the tendon from damage, but it backfires. The friction from all that rubbing causes the bursa to become inflamed and swell. This causes the bump to become red, hot and stick out even further. Much like a sore thumb, it then gets irritated by even the softest shoes.<br><br>Symptoms<br>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.<br><br>Diagnosis<br>Carrying out a diagnosis for bursitis is fairly straightforward. The doctor will examine the affected area and ask the patient some questions about his/her recent activities. If the patient has a high temperature the physician may take a small sample of fluid from a bursa near the affected body part. The sample will be tested for bacteria, and perhaps also crystals. If the patient does not get better after treatment the doctor may carry out further tests so that he/she can eliminate the possibility that the symptoms might not be due to something else. These may include an x-ray, to make sure no bones are broken or fractured. Blood tests, to check for rheumatoid arthritis. A CT scan or MRI scan to see if there is a torn tendon.<br><br>Non Surgical Treatment<br>Medications may be used to reduce the inflammation and pain of retrocalcaneal bursitis. Nonsteroidal anti-inflammatory drugs such as ibuprofen, naproxen and ketoprofen can be purchased without a prescription and used to treat mild to moderate pain. These drugs are often used in combination with a physical therapy program or other retrocalcaneal bursitis treatments.<br><br>Surgical Treatment<br>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 symptoms.<br><br>Prevention<br>After taking a history and performing a physical examination, your physician may order x-rays to rule out other disorders. Your doctor may administer injections of corticosteroids and a local anesthetic to reduce swelling and ease pain. Also, to reduce swelling, your physician may draw excess fluid from the bursa with a syringe and then tightly wrap and compress the joint with an elastic bandage. In severe, persistent cases surgery to remove the bursa may be necessary. For infectious bursitis, antibiotics will be prescribed.