Retrocalcaneal and retroachilles bursitis are both common types of bursitis that can cause pain at the back of the foot, just above the heel. This pain, and often swelling, occurs when one or both bursae at the back of the heel become irritated and inflamed.

Because they have similar symptoms, heel bursitis is sometimes confused with problems affecting the Achilles tendon, which is a long strip of fibrous tissue that connects the back of the heel to the calf muscle.

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Other times, Achilles tendon problems may bring about the bursitis. For example, tight calf muscles can contribute to chronic pulling at the point where the Achilles tendon inserts into the back of the heel. This pulling can result in friction and irritation that eventually lead to bursitis.

Retrocalcaneal Bursitis

Retrocalcaneal bursitis is the inflammation of the retrocalcaneal bursa, which is located behind the heel bone, also known as the calcaneal bone (hence the name retrocalcaneal). The retrocalcaneal bursa is a thin, slippery, fluid-filled sac that serves as a both a cushion and lubricant between the heel bone and the Achilles tendon.

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Inflammation of the retrocalcaneal bursa usually results from irritation of the bursa. This irritation may be due to certain activities; an underlying health condition such as arthritis; or an abnormality of the foot, such the development of a boney prominence on the calcaneal bone, called a Haglund's deformity.

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Retroachilles Bursitis

Another bursa, called the retroachilles bursa, is located between the Achilles tendon and skin at the back of the heel. This bursa is also susceptible to inflammation. Retroachilles bursitis is almost exclusively associated with shoes that dig into the back of the heel.

Retroachilles and retrocalcaneal bursitis can occur at the same time, which can make the pain and inflammation more difficult to treat.

Septic Bursitis

Although rare, bursitis also may be caused by an infection, known as septic bursitis. This is a serious medical condition that requires antibiotics to treat the infection and prevent its spread to other points in the body or the bloodstream. Septic bursitis may cause the back of the ankle to become red and hot. The person may also get the chills or fever and may feel sick and tired. Typically this type of bursitis would be suspected if there has been any history of an open wound in the area, such as a blister.

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This article provides a review of retrocalcaneal bursitis causes, diagnosis, and treatment options. While this article focuses on retrocalcaneal bursitis, many of the symptoms and treatments for retroachilles bursitis are the same.

Thankfully, many cases of aseptic retrocalcaneal and retroachilles bursitis can be treated effectively at home. Cases that do not respond to home treatment, as well as suspected cases of septic bursitis, should be addressed by a podiatrist or physician.

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Written by Jesse Burks, DPM
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