A bursa is a small sac filled with fluid. It helps to reduce friction between tendons, bones and skin. There are several bursae around the Achilles tendon and the back of the heel bone.

If a bursa becomes irritated, it can become swollen, painful and red. This is known as bursitis.

Bursitis of the Achilles tendon is usually caused by prolonged pressure or friction on the back of the heel. This can irritate the bursa.

Possible causes include:

shoes with a hard heel edge;
shoes that are too tight;
a lump at the back of the heel bone;
a lot of strain from sport or walking;
an unstable gait;
an abnormal position of the foot;
Achilles tendon complaints;
extra pressure on the heel, for example due to being overweight.

The symptoms are usually felt at the back of the heel, near or just beside the Achilles tendon.

You may notice that:

there is a painful swelling at the back of the heel;
the skin feels red or warm to the touch;
shoes cause pressure pain;
getting up after resting is painful;
exercising or walking for long periods makes the symptoms worse;
the Achilles tendon can also be sensitive.

A healthy lifestyle can influence the development and recovery from bursitis of the Achilles tendon. Sufficient sleep, a healthy diet and a good balance between exercise and rest help the body to recover. It is important to keep exercising regularly, but the level of exertion must be appropriate for what the heel and Achilles tendon can cope with.

Also mental health plays a part. Stress, anxiety or the pressure to perform can mean that someone recovers less effectively or takes on too much too soon. Fear of pain, on the other hand, can lead to someone not moving enough. Both can slow down recovery. Our lifestyle coaches can help in fostering healthy habits, such as getting enough sleep and eating a healthy diet.

You can, above all, try to reduce the pressure on the bursa yourself.

To reduce symptoms, you can:

temporarily avoid shoes with a hard heel edge;
reduce pressure on the back of the heel;
temporarily adjust the exercise load;
don’t put up with the pain for too long;
keep a close eye on your skin if it becomes red or feels warm;
Please contact us if you have a fever, obvious signs of inflammation or rapidly increasing pain.

Our podiatrists We investigate what causes the pressure or friction. We look at your foot position, gait, shoes and the location of the swelling.

Treatment may consist of:

shoe advice;
relieve pressure with temporary relief;
orthopaedic insoles to improve weight distribution;
tape as a temporary support;
advice on sport and recovery;
ultrasound examination;
collaboration with a physiotherapist.

If the inflammation persists or medical treatment appears to be necessary, we will refer you back to your GP.

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Bursitis of the Achilles tendon

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