Heel Bursitis

Heel pain can be more than just a nuisance—it can interfere with your daily activities and overall quality of life. One common but often overlooked cause of heel pain is heel bursitis, a condition that affects the small, fluid-filled sacs known as bursae. These bursae act as cushions between bones and soft tissue, and when they become inflamed, pain and discomfort can quickly follow.

In this post, we’ll break down what heel bursitis is, explore its causes, identify the symptoms to look out for, and share treatment options to help you get back on your feet—literally.

What Is Heel Bursitis?

Heel bursitis occurs when one of the bursae located near the heel becomes inflamed. There are two primary types that affect the heel:

Retrocalcaneal bursitis: Inflammation of the bursa located between the Achilles tendon and the heel bone (calcaneus).

Subcutaneous calcaneal bursitis (also called Achilles bursitis): Involves the bursa that sits just under the skin at the back of the heel.

Both types can cause pain, swelling, and tenderness around the heel, but they may stem from different causes and require slightly different treatment approaches.

Causes of Heel Bursitis

Heel bursitis can result from a range of factors, many of which involve overuse or repetitive stress on the foot. Common causes include:

Repetitive activity or overuse: Sports or exercises that involve a lot of running or jumping can irritate the bursa.

Improper footwear: Shoes with poor support or a stiff heel counter can put excessive pressure on the back of the heel.

Sudden increase in activity level: A quick jump in physical activity, especially without proper conditioning, can stress the heel.

Foot deformities: Conditions like high arches or flat feet can alter gait and put extra strain on the heel.

Trauma or direct impact: A blow to the heel area can inflame the bursa.

Medical conditions: Rheumatoid arthritis, gout, or infections can also lead to bursitis.

Symptoms to Watch For

Symptoms of heel bursitis can vary depending on the type and severity of inflammation, but common signs include:

• Pain and tenderness around the back or bottom of the heel, especially when walking or running.
• Swelling or warmth near the affected area.
• Redness over the heel (especially in subcutaneous bursitis).
• Stiffness or difficulty moving the ankle, particularly in the morning or after periods of inactivity.
• Pain that worsens when wearing certain shoes, especially those that press on the back of the heel.

Treatment Options

The good news is that heel bursitis often responds well to conservative treatment. Here are some commonly recommended approaches:

1. Rest and Activity Modification

Avoid high-impact activities that aggravate the heel, such as running or jumping. Switch to low-impact exercises like swimming or cycling until symptoms improve.

2. Ice Therapy

Applying ice packs to the affected area for 15–20 minutes several times a day can help reduce inflammation and relieve pain. Ice massage using a Styrofoam cup frozen full of water and tearing off enough of the rim of the cup can be a powerful anti-inflammatory. Rub hard for 10-12 minutes over the painful area(s).

3. Proper Footwear

Wearing well-cushioned, supportive shoes can reduce pressure on the heel. Heel lifts or orthotic inserts may also help improve foot alignment and relieve stress.

4. Medication

Over-the-counter anti-inflammatory drugs like ibuprofen or naproxen can reduce pain and swelling.

5. Stretching and Physical Therapy

Targeted exercises to stretch the Achilles tendon and strengthen surrounding muscles can improve flexibility and support recovery.

6. Corticosteroid Injections

In some cases, a doctor may recommend a corticosteroid injection to reduce severe inflammation.

7. Surgical Intervention

Surgery is rarely necessary, but in persistent or severe cases that don’t respond to other treatments, it may be considered to remove the inflamed bursa.

When to See a Doctor

If heel pain persists despite rest and home care, or if you notice signs of infection (such as increased redness, warmth, or fever), it’s important to seek medical attention. A healthcare provider can confirm the diagnosis through physical examination and imaging tests like X-rays or MRI, and recommend a personalized treatment plan.

Final Thoughts

Heel bursitis can be painful and frustrating, but with the right care and attention, most people recover fully and return to their normal activities. Understanding the causes and recognizing the symptoms early on is key to preventing further damage and speeding up recovery. If heel pain is affecting your lifestyle, don’t ignore it—your feet will thank you for it.