Achilles Tendon Bursitis, also known as retrocalcaneal bursitis, is a condition that primarily affects athletes, especially runners, but it can occur in anyone. It is often confused with Achilles tendinitis due to similar symptoms. In some cases, both conditions can occur together, and when they do, it is referred to as Haglund’s syndrome. If you are experiencing pain in your lower leg and heel, especially if you’re a runner, it could be due to Achilles tendon bursitis. Proper treatment can help alleviate pain and promote healing.

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Causes of Achilles Tendon Bursitis

Achilles tendon bursitis occurs when the retrocalcaneal bursa, a small fluid-filled sac at the back of the ankle, becomes irritated or inflamed. This bursa acts as a cushion and lubricant for the ankle joint.

Possible causes of Achilles tendon bursitis include:

  • Aging: As you age, the retrocalcaneal bursa can deteriorate, and conditions like rheumatoid arthritis or gout can contribute to this process.
  • Overuse: Excessive physical activity, such as uphill running, jumping, or long-distance walking, especially without proper conditioning, can irritate the bursa.
  • Trauma: Sudden injury or trauma, such as from a fall, or rigid or poorly fitted shoes, can cause the bursa to become inflamed.

Symptoms of Achilles Tendon Bursitis

Unlike Achilles tendinitis, which is typically located slightly higher on the lower leg, Achilles tendon bursitis causes pain primarily at the back of the heel.

Symptoms may include:

  • Pain when rising on toes: It may become painful to stand on your toes or wear high heels due to pressure on the inflamed area.
  • Inflammation and tenderness: The skin around your heel can feel swollen, warm, and may appear red.
  • Heel pain: Pain tends to increase when walking, running, or touching the inflamed area.
  • Stiffness: Swelling of the bursa can cause stiffness in the back of the ankle.

Treatment of Achilles Tendon Bursitis

Many cases of Achilles tendon bursitis can be treated with home care. However, if symptoms persist, additional treatments from a healthcare provider may be necessary.

Home Care

The most important step in treatment is to rest and avoid activities that could worsen the condition.

Common home-care remedies include:

  • Anti-inflammatory medication: Over-the-counter medications like ibuprofen or aspirin can reduce pain and inflammation.
  • Heel wedges: These can be placed in your shoes to minimize pressure on the Achilles tendon.
  • Ice: Apply cold therapy or ice to the sore heel multiple times a day to reduce swelling.
  • Rest and elevation: Limit activity on the injured leg, and elevate it during rest periods to help reduce swelling.

These treatments can be used individually or in combination to relieve symptoms.

Physician-Administered Treatments

If home remedies do not provide sufficient relief, your doctor may recommend additional treatments, including:

  • Immobilization: If bursitis is combined with Achilles tendinitis, your doctor may apply a temporary cast to keep the ankle still and allow healing.
  • Physical therapy: Exercises to improve strength and flexibility in the ankle may be recommended.
  • Steroid injections: In some cases, steroid injections may be administered into the retrocalcaneal bursa (but not the Achilles tendon itself) to reduce inflammation.
  • Surgery: Surgical intervention is rarely needed but may be considered to remove the retrocalcaneal bursa if other treatments have not worked.

Conclusion

If you’re experiencing pain in the back of your heel and suspect Achilles tendon bursitis, start with rest, ice, and anti-inflammatory medication. If symptoms persist or worsen, consult your doctor for further treatment options, which may include physical therapy, steroid injections, or, in rare cases, surgery.