Bursitis at the Back of the Heel

A bursa may become irritated between the skin and Achilles tendon or deeper, between the tendon and heel bone. Shoes with a firm heel counter can rub the outer area, while running, uphill activity or a rapid training change can load the deeper tissues.

Pain may be felt when footwear presses on the bump, during push-off, or after activity. Swelling can sit beside the tendon rather than in the ankle joint. Achilles tendinopathy and a prominent heel bone can coexist, so an examination should distinguish the tender structure before treatment is chosen.

Choose footwear that does not press directly on the sore area; a soft or open-backed option may reduce rubbing temporarily. Scale back hills, jumping and running if they reproduce pain. Cooling the area through a cloth after activity can settle discomfort, but avoid aggressive massage over a swollen bursa.

A physiotherapist can assess ankle movement, calf capacity, footwear and recent training changes, then build activity back gradually. Medication may not suit everyone, particularly people with stomach, kidney, bleeding or other medical concerns, so check with a clinician or pharmacist before using it.

Get prompt care for warmth, spreading redness, drainage, fever or rapidly increasing swelling. Sudden pain with a snap, inability to push off the foot, or a new gap in the Achilles area needs urgent assessment for a tendon injury rather than routine self-care.

Book an appointment if footwear changes and reduced loading do not settle the problem, if the swelling repeatedly returns, or if walking remains altered. Earlier review is sensible when diabetes, reduced sensation, poor circulation or a skin wound affects the foot.

Ask whether the tender tissue is a superficial bursa, a deeper bursa or the Achilles tendon. Discuss the footwear features to change, which calf exercises are suitable, and what signs should guide a safe return to running or sport.