Heel bursitis, known in medical terms as bursitis calcanea, is a painful inflammation of the bursa in the heel area. Bursae are small, fluid-filled cushions found at various points in the body. They sit between bones, tendons, and muscles, acting as a kind of padding. They stop tissues from rubbing against each other during movement and protect sensitive structures from too much pressure.
Where exactly does the inflammation occur?
There are several bursae in the heel area. They are found mainly where tendons attach directly to the heel bone, or where shoes press against the skin. Most often, the bursa affected is the one that sits between the heel bone and the Achilles tendon. Sometimes it is the one found just beneath the skin at the back of the heel. If this area is thrown off balance by friction, pressure, or overuse, the bursa can become inflamed and painfully swollen.
Typical symptoms of heel bursitis
Heel bursitis usually makes itself known through a throbbing or stabbing pain that appears directly over the affected area. The spot is often red, warm to the touch, and swollen. Even light pressure, such as wearing shoes, can feel very uncomfortable. The symptoms are often at their worst after long periods of walking, physical activity, or first thing in the morning after getting up.
Some people find they can barely stand without a pulling or burning sensation in the heel. In some cases the inflammation develops gradually, while in others there is a sudden and noticeable worsening. If heel bursitis is left untreated, it can become chronic and keep flaring up.
What causes heel bursitis?
Overuse is often behind the inflammation. This can happen, for example, when shoes are too tight and constantly rub against the heel, or when too much pressure is placed on the tendons and bursae during sport, such as running, football, or hiking. Foot misalignments, such as flat feet or a splayed foot, can also mean that load is not distributed evenly, causing the bursa to be overstrained.
In some cases, the inflammation develops after an injury, such as a knock to the heel or a fall. Less commonly, a bacterial infection is the cause, where bacteria enter the bursa through small breaks in the skin. In certain underlying conditions such as rheumatism or gout, the risk of bursitis is generally higher.
Is heel bursitis dangerous?
Heel bursitis is painful and can noticeably limit movement, but in most cases it is not dangerous. It usually heals well once the cause is identified and the strain on the heel is reduced. That said, a persistent or very pronounced inflammation should not be taken lightly. Especially if fever, severe redness, or a general feeling of being unwell appear alongside it, a bacterial infection may be present, which will need targeted treatment.
Many people wonder whether the inflammation will go away on its own or whether lasting damage is a risk. As a rule, the swelling settles within a few days to weeks if the affected area is rested. However, if the strain continues or the inflammation is repeatedly irritated, the bursa can change permanently or even calcify, which may make the symptoms worse in the long term.
How is heel bursitis treated?
The most important step is to take the pressure off the heel and avoid anything that further irritates the bursa. Often it is enough to rest from sport for a few days, wear comfortable open shoes, and cool the heel. Cold packs or cool compresses help to ease the swelling and the pain. Sometimes doctors prescribe anti-inflammatory medication to help the symptoms settle more quickly.
If the inflammation is very severe or keeps coming back, targeted physiotherapy can be helpful. A physiotherapist can show how to strengthen the muscles around the heel and how to avoid placing uneven load on it. Special insoles can also help to distribute pressure across the heel more evenly. In rare cases, if pus forms or the inflammation does not respond to other measures, the bursa may be drained with a needle or even surgically removed.
What can you do yourself to prevent it?
To help prevent heel bursitis, it is worth making sure your shoes fit well and do not press or rub. People who walk a lot or are physically active should check their footwear regularly and replace it in good time when the cushioning starts to wear down. Warming up before sport and doing targeted stretching exercises for the calf muscles can also help reduce pressure on the heel.
At the first signs, such as pain on pressure, redness, or swelling, it is a good idea to take a break early and rest the foot. This can often prevent the inflammation from getting worse or becoming chronic.
Heel bursitis is unpleasant, but in most cases it responds well to treatment. With a little patience, rest, and the right steps, the symptoms usually clear up within a few weeks.
