Bursitis in the heel: symptoms and next steps

A bursa between the Achilles tendon and heel bone can cause deeper pain at the back of the heel, while a superficial bursa can become sore where a shoe rubs. The area may feel tender or swollen, and uphill walking or shoes with a firm heel counter may aggravate symptoms.

Achilles tendinopathy, a prominent heel bone, skin irritation and other causes of heel pain can overlap with bursitis. Examination focuses on the precise tender spot, ankle movement, tendon strength, footwear and whether pain occurs under the heel instead of behind it.

Switch temporarily from running, jumping or steep hills to an activity that does not reproduce the pain. Choose shoes that do not press on the tender area; a soft-backed design may help superficial irritation. Avoid abruptly stretching the heel into pain or cutting into footwear in a way that creates a hard edge.

As discomfort settles, restore activity gradually. A physiotherapist can assess calf capacity, ankle mobility and training changes. Because a heel lift or insert changes load through the foot, it should match the location and cause of symptoms rather than be selected only from the word bursitis.

Arrange prompt assessment if the heel becomes red, hot or increasingly swollen, especially with fever, drainage, a blister or broken skin. Seek urgent help after a sudden snap or injury if you cannot push off the foot, because the Achilles tendon may be injured.

A clinician should also evaluate pain that prevents weight-bearing, keeps returning or persists despite sensible load changes. Numbness, a cold or unusually pale foot, or rapidly spreading swelling requires urgent medical attention.

Ask which bursa or tendon is affected, whether footwear is contacting the painful spot and which activities can be maintained. Clarify how to rebuild walking or running load, whether rehabilitation should target calf strength, and whether an injection near the Achilles tendon carries location-specific concerns.