UMEM Educational Pearls

Category: Orthopedics

Title: Posterior heel pain

Keywords: Bursitis, heel pain (PubMed Search)

Posted: 11/27/2010 by Brian Corwell, MD (Updated: 11/1/2024)
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Chief complaint: “Posterior heel pain”

 

http://www.aidmybursa.com/_img/ankle-retrocalcaneal-subcutaneous-bursitis.jpg

Retrocalcaneal bursitis

The retrocalcaneal bursa is located between the Achilles tendon and the posterior superior border of the calcaneus.

H&P: Inflammation and pain may follow repetitive dorsi/plantar flexion of the ankle (excessive running, jumping activities). Tenderness anterior and superior to the Achilles insertion on the heel.

Treatment: Minimize weight bearing. ½ inch elevation. NSAIDs.

 

Posterior calcaneal bursitis

This bursa is subcutaneous, just superficial to the insertion of the Achilles tendon.

H&P: Inflammation and pain may follow irritation from the upper border of the heel counter of a shoe. Posterior heel pain. Tender “bump” (the inflamed and swollen bursa) on the back of the heel.

http://podiatry.files.wordpress.com/2006/12/patient2.jpg

 

Treatment: Opened-heeled shoes, sandals, or placement of a “U-shaped” pad between the heel and the counter. NSAIDs. Advance to shoes with soft or less convex heel counters.

References