Achilles Tendinitis and Retrocalcaneal Bursitis Treatment

Diagnosis and Findings

The American Academy of Family Physicians notes that moderate dorsal calcaneal spurring is a common finding in patients with heel pain, and is associated with inflammation and bone spurs on the back of the heel bone where the Achilles tendon attaches 1
Patients with Achilles tendinitis often have a thickened Achilles tendon, indicating inflammation, with a typical thickness of around 6mm compared to the unaffected side 1, 2
Increased fluid in the retrocalcaneal bursa is a sign of inflammation and bursitis, which can be associated with heel pain and Achilles tendinitis 1, 3

The American Academy of Family Physicians recommends reducing pressure on the area by wearing open-backed shoes to decrease pressure on the inflamed area, and using heel lifts or orthotic devices to reduce tension on the Achilles tendon 1, 4
Applying ice through a wet towel for 10-minute periods can help reduce inflammation, and limiting activities that worsen pain is also recommended, although complete rest is not necessary 5, 6
Regular stretching exercises, such as calf muscle and Achilles tendon stretching, can help improve flexibility and reduce pain, and should be performed daily 1, 4
Weight loss can reduce stress on the tendon and improve symptoms, especially in overweight patients 1, 4

If conservative treatment fails, seeking specialist referral to a podiatric foot and ankle surgeon may be necessary, and immobilization with a walking boot or cast may be recommended for more stubborn cases 1, 4
Advanced imaging, such as MRI, may be needed to assess the condition more thoroughly and guide further treatment 5
Surgical removal of the prominent bone spur and inflamed bursa may be considered for persistent bursitis with bone spurs, and debridement of damaged tendon tissue may be necessary for chronic tendinitis 4