Achilles tendon bursitis is inflammation of the fluid-filled sac (bursa) located either between the skin of the back of the heel and the Achilles tendon (posterior Achilles tendon bursitis) or in
front of the attachment of the Achilles tendon to the heel bone (anterior Achilles tendon bursitis, retrocalcaneal bursitis). Typical symptoms include swelling and warmth and a tender spot at the
back of the heel. The diagnosis is based on symptoms, an examination, and sometimes x-rays. Treatment is aimed at relieving the inflammation and, depending on the location of the Achilles tendon
bursitis, eliminating the pressure on the back of the heel. The Achilles tendon is the tendon that attaches the calf muscles to the heel bone. Posterior Achilles tendon bursitis is often associated
with formation of a bone prominence called Haglund deformity or ?pump bump? on the heel bone. Anterior Achilles tendon bursitis is also called Albert disease or retromalleolar bursitis.
Bursitis, tendinitis, and other soft tissue rheumatic syndromes typically result from one or more factors. These include: Play or work activities that cause overuse or injury to the joint areas
Incorrect posture Stress on the soft tissues from an abnormal or poorly positioned joint or bone (such as leg length differences or arthritis in a joint) Other diseases or conditions (rheumatoid
arthritis, gout, psoriasis, thyroid disease, or an unusual drug reaction) Infection.
Pain at the back of the heel, especially when running uphill. Pain may get worse when rising on the toes (standing on tiptoes). Tenderness at the back of heel. Swelling at the back of heel.
After you have described your foot symptoms, your doctor will want to know more details about your pain, your medical history and lifestyle, including whether your pain is worse at specific times of
the day or after specific activities. Any recent injury to the area. Your medical and orthopedic history, especially any history of diabetes, arthritis or injury to your foot or leg. Your age and
occupation. Your recreational activities, including sports and exercise programs. The type of shoes you usually wear, how well they fit, and how frequently you buy a new pair.
Non Surgical Treatment
Most bursitis cases can be treated by the patient without having to see a doctor. A trip to a pharmacy, a conversation with the pharmacist, and some self-care techniques are usually enough. The NHS
(National Health Service, UK) recommends PRICEM, a self-care management approach. PRICEM stands for Protection. Rest. Ice. Compression. Elevation. Medication. Protect the affected area, Some people
place padding to protect the affected bursae from any blow. Rest. Do not exercise or use the joints in the affected area unless you really have to. Let it rest. Bursitis is a condition that responds
well to rest. Ice packs. Ice packs can help reduce pain and inflammation. Make sure you do not place the ice directly on the skin, use a pack or towel. A small pack of frozen vegetables are ideal.
Raise the affected area. If you can, lift the affected area, raise it, less blood will gather there. This may help reduce the inflammation. Painkillers. Ibuprofen is an effective painkiller for
treating pain, it also reduces inflammation. Steroids. For more severe symptoms the doctor may inject steroids into the affected area. Steroids block a body chemical called prostaglandin.
Prostaglandin causes inflammation. Steroids may raise the patient's blood pressure if used for too long, as well as increasing his/her risk of getting an infection. UK doctors are advised not to give
more than three steroid injections in one year. Antibiotics. If the fluid test confirms that there is a bacterial infection, the doctor will probably prescribe antibiotics. These will be administered
orally (via mouth).
Surgery is rarely done strictly for treatment of a bursitis. If any underlying cause is the reason, this may be addressed surgically. During surgery for other conditions, a bursa may be seen and