Below is a list of common signs and symptoms of heel bursitis, including retrocalcaneal bursitis and calcaneal bursitis. Recognizing and treating symptoms early can prevent heel bursitis from becoming chronic.
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Heel Bursitis Pain
The back of the heel may become painful gradually, over days or weeks. Applying pressure to the back of the heel can cause or worsen pain. Wearing shoes may become uncomfortable.
Flexing or extending the ankle may squeeze the swollen bursa, triggering pain. For example, retrocalcaneal bursitis pain may be worse when standing on tip-toes. 1 Ma, CB. Bursitis of the heel. MedlinePlus, US National Library of Medicine. Updated August 15, 2018. Accessed January 25, 2021. https://medlineplus.gov/ency/article/001073.htm
Signs and Symptoms of Heel Bursitis
In addition to pain, there are several other possible signs and symptoms of heel bursitis. A person with heel bursitis may notice one or more of the following:
Swelling at the back of the heel
Bursitis causes a bursa to fill with excess fluid. In retrocalcaneal bursitis, this excess fluid may cause visible swelling in the area just above the back of the heel bone.
The swelling caused by calcaneal bursitis—the form of heel bursitis associated with wearing tight shoes—may be more distinct, appearing as a hard lump behind the heel.
The swelling at the back of the heel may make it difficult to fully bend or straighten the ankle.
Both retrocalcaneal and calcaneal bursitis can cause the skin at the back of the heel to look red. This discoloration is more likely to occur in calcaneal bursitis because the calcaneal bursa is closer to the surface of the skin. 2 van Dijk CN, van Sterkenburg MN, Wiegerinck JI, Karlsson J, Maffulli N. Terminology for Achilles tendon related disorders. Knee Surg Sports Traumatol Arthrosc. 2011 May;19(5):835-41. Epub 2011 Jan 11. PubMed PMID: 21222102; PubMed Central PMCID: PMC3076576. DOI: 10.1007/s00167-010-1374-z
The skin at the back of the heel may also appear red skin if it has been irritated by ill-fitting shoes.
If the skin at the back of the heel feels particularly hot to the touch, it may be a sign of septic bursitis. This condition is caused by an infection. Though uncommon, septic heel bursitis is a serious condition, and patients should seek medical care to ensure the infection does not spread or become chronic.
Fever or chills
A body-wide fever or chills is a sign of infection. When fever or chills appear with other heel bursitis symptoms, especially hot, red skin at the back of the heel, it may be a sign of septic bursitis. As stated above, people who suspect septic bursitis are advised to seek urgent medical care.
See Septic Bursitis
Treating heel bursitis can prevent the condition from becoming chronic and reduce the risk of other future problems. Septic bursitis should be treated immediately.
A health care provider can evaluate the affected foot and determine if symptoms are caused by bursitis or something else. When making a diagnosis, a health care provider may consider a patient’s medical risk factors and lifestyle, such as exercise routine.
- 1 Ma, CB. Bursitis of the heel. MedlinePlus, US National Library of Medicine. Updated August 15, 2018. Accessed January 25, 2021. https://medlineplus.gov/ency/article/001073.htm
- 2 van Dijk CN, van Sterkenburg MN, Wiegerinck JI, Karlsson J, Maffulli N. Terminology for Achilles tendon related disorders. Knee Surg Sports Traumatol Arthrosc. 2011 May;19(5):835-41. Epub 2011 Jan 11. PubMed PMID: 21222102; PubMed Central PMCID: PMC3076576. DOI: 10.1007/s00167-010-1374-z