Bursitis of the Foot

Updated 3/18/2022
Bursitis Foot, University Foot and Ankle Institute

What is Foot Bursitis?


Foot bursitis is a condition that involves inflammation and fluid buildup of the bursa sac. A bursa is a small slippery fluid-filled sac; imagine a water balloon that forms over a joint to decrease friction and act as a lubricant between the bones and surrounding skin, muscles, ligaments, and tendons (or soft tissues for short). 


The bursa sac consists of a thin-walled membrane (called the synovial membrane or synovium) that produces and contains fluid (known as, you guessed it, synovial fluid). The bursa can become irritated and inflamed due to excessive repetitive joint motion, injury, a bone deformity, and even due to underlying medical conditions like arthritis. 

Several Areas in Your Feet Can Be the Source of Foot Bursitis Pain: 

Back of the heel: The retrocalcaneal bursa is located in the back of your heel bone between the bone and the Achilles tendon. This bursa reduces friction and pressure from your heel bone on your Achilles tendon when you’re standing.


Bottom of your heel: A Sub-calcaneal bursa is located between the heel bone and the plantar fascia (the thick ligament that connects your heel to the front part of your foot). Sub-calcaneal bursa symptoms are often very similar to plantar fasciitis


On your Achilles: The other bursa, known as the retroachilles bursa, sits between your Achilles tendon and the skin at the back of your heel. Retroachilles bursitis is almost always due to wearing shoes that are too tight and dig into the back of your heel. Its telltale sign is a tender bony posterior heel bump known as a “pump bump” (or Haglund’s deformity).


On a bunion or tailors bunion: There are also bursae sacs near the joints of your toes that help cushion the bone. When a toe joint gets bigger because of a bunion, the bursa can become painful and swollen, resulting in bursitis. Bursitis may cause additional pain and can damage the cartilage surrounding the joint. This may lead to arthritis.



What are the Symptoms of Foot Bursitis?

Common symptoms of foot bursitis pain can include:

  • Pain with movement of the joint
  • Swelling, redness, or stiffness around the joints
  • Heat emanating from the painful area
  • Pain when walking or running
  • Increased pain associated with standing on tiptoes or bending the foot



What Causes Bursitis in the Foot?

More often than not, foot bursitis is due to an overuse injury that can occur in sports involving repetitive impact (like running). Bursitis can also result from a direct blow to the foot. If you think about it, your feet undergo a lot of pounding, particularly if you walk or run on hard surfaces. Being overweight can also place undue demand on your feet.


Other causes of bursitis in the foot can include:

  • Wearing ill-fitting shoes or shoes not appropriate for a particular sport or activity level
  • Repetitive running, jumping, or other ballistic movements
  • Walking in high heels for prolonged periods of time
  • Failing to warm up and stretch your calf muscles and Achilles tendon before exercising
  • A Haglund’s deformity (where a bump forms on your heel as a result of shoe friction)
  • Gout
  • Underlying medical conditions like rheumatoid arthritis, gout, diabetes, or thyroid disorders
  • Infection (although this is extremely rare in the foot bursae)
  • Bunion



How is Foot Bursitis Diagnosed?

Your podiatrist will examine your foot and ask you to describe your pain and when it first appeared. You’ll be asked to provide details about your daily activities, such as what type of exercise you participate in, how long you perform certain types of activities, whether your job or sport involves spending a lot of time standing or performing repetitive motions.


In addition to your exam and activity history, your doctor will want to take a detailed medical history to look for other conditions that might cause pain in the heel. Some tests might be needed if your doctor suspects an injury, an infection, or a fracture. These can include:

  • Xrays
  • Removal of fluid from the bursa to check for gout or infection
  • An MRI
  • An ultrasound



What are the Treatments for Foot Bursitis?

Nearly everyone gets better with time and conservative measures that can include:

  • Rest: If you are experiencing a lot of pain, you must stop running or doing whatever activity is causing your heel to hurt. Because this is an inflammatory problem, continuing to exercise will only worsen your condition. You may require two or more weeks of rest, but if you don’t give your inflamed bursa a rest, your healing will only take longer.
  • Icing and elevation of the foot might be recommended during the early stages of your treatment.
  • Over-the-counter anti-inflammatory medications (such as naproxen or ibuprofen) can help with bursitis foot pain and swelling.
  • Proper fitting shoes: Your podiatrist will want to look at your athletic shoes to make sure that they’re not contributing to the problem. He or she might recommend that you wear heel cups or arch supports to provide additional cushioning to the affected area. In rare cases, a custom-made orthotic might be indicated.
  • Physical therapy: A physical therapist will work with you to develop a safe exercise regimen for meeting your fitness goals while avoiding the type of repetitive activities that can irritate your foot bursa. In physical therapy, you will also be taught the proper way to stretch your calf muscles and Achilles tendon to avoid future problems.
  • Foot splints may be prescribed to be worn at night to stretch particularly tight Achilles tendons.


In rare instances in which folks fail to improve with conservative treatment, a cortisone injection into the heel might be recommended. But this step is taken only after careful consideration because cortisone has known side effects. For those extremely rare patients who remain symptomatic after six months, surgery might be indicated.



How Can You Prevent Foot Bursitis? 

If you’ve had foot bursitis, you know that it isn’t fun. The good news is that there are several ways to prevent heel bursitis pain from starting or returning:

  • Well. Fitting. Shoes. This is essential. Your shoes are one of the most common causes of bursitis. Athletic shoes should be comfortable and provide adequate support and cushioning to your heel area. Also important is to make sure that the heels aren’t worn down.
  • Padded socks will go a long way toward protecting your feet and preventing bursae from forming.
  • Invest adequate time in stretching your calf muscles and Achilles tendons before all exercise or sports activities.
  • Avoid going barefoot on hard, rocky, or uneven surfaces.
  • If you’re a treadmill user, make sure to vary the incline to reduce stress on your heels.
  • Keep a healthy weight. You’d be surprised as to how lightening the load will lessen the stress on your heels, not to mention other affected joints, like your knees and hips.



Why UFAI is the Best Choice for Treating Foot Bursitis

When you choose the University Foot and Ankle Institute, you can rest assured that you have chosen a compassionate team of experts with decades of combined experience. Our team of physicians uses state-of-the-art equipment and offers the latest diagnostic and curative treatments available. Our doctors enjoy the highest success rates in the nation.

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