Insertional heel pain

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.

Over-the-counter or custom heel wedges may help to decrease the stress placed on the attachment of the achilles tendon and the associated bursa.

If these interventions are ineffective, then some health care providers may inject a small amount of steroids into the bursa. If the condition is associated with Achilles tendonitis, then casting the ankle to prevent motion for several weeks can be effective. Very rarely, surgery may be necessary to excise the inflamed bursa.

This condition has an excellent prognosis and usually resolves in several weeks once proper treatment is initiated.

Complications are uncommon. If the bursitis is associated with tendonitis, then tendon rupture is a possible complication. Steroid injections have also been associated with tendon rupture, especially if done too frequently.

If you have heel pain or symptoms of retrocalcaneal bursitis and these symptoms do not improve with rest, contact your health care provider for proper evaluation and treatment.