Bursitis accounts for 0.4% of all visits to primary care clinics. The most common locations of bursitis are the subdeltoid, olecranon, ischial, trochanteric, and prepatellar bursae. The incidence of
bursitis is higher in athletes, reaching levels as high as 10% in runners. Approximately 85% of cases of septic superficial bursitis occur in men. A French study aimed at assessing the prevalence of
knee bursitis in the working population found that most cases occurred in male workers whose occupations involved heavy workloads and frequent kneeling. Mortality in patients with bursitis is very
low. The prognosis is good, with the vast majority of patients receiving outpatient follow-up and treatment.
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.
Medical experts strongly recommend that you consult a doctor if you have any of the symptoms below. Disabling joint pain that prevents you from doing your daily activities. Pain that lasts for more
than two weeks. Excessive swelling, redness, bruising or a rash around the painful joint. Sharp or shooting pain, especially when you exercise or do something more strenuous. A fever. Any of the
above could be a sign of infection, a condition such as arthritis or a more serious injury such as a tendon tear that may require medical attention.
Diagnosis is first by clinical suspicion of symptoms. This can be mistaken for gout or infection especially in the big toe region. A diagnosis of bursitis is usually used in combination of the
underlying cause, for instance a bunion deformity, Haglund's deformity, or Heel Spur Syndrome. Many times the cause needs to be addressed to rid the problem of bursitis.
Non Surgical Treatment
The initial treatment for retrocalcaneal bursitis is to avoid activities that cause pain and take non-steroidal anti-inflammatory medications (for example, ibruprofen). Your doctor may recommend
icing the heel several times a day and may prescribe physical therapy to improve flexibility and strength around the ankle. Physical therapy serves two functions, it can help the bursitis improve and
it can help prevent future recurrences.
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