What should you know about subcalcaneal bursitis?

A subcalcaneal bursa cushions tissues beneath the heel bone. Repeated impact, prolonged standing, a change in activity, footwear pressure or a direct injury can irritate it and make the underside of the heel sore.

Pain may be focused under the heel and may be worse with weight bearing or pressing the area. Plantar fascia problems, a stress injury, nerve irritation or other foot conditions can feel similar. Examination helps identify the tender point and assess walking, skin and foot movement.

Swelling around the foot or ankle may have different causes. Tell a clinician if the area is warm, red, suddenly swollen or painful at rest.

Reduce impact activities for a short period and choose supportive, well-fitting footwear. Avoid walking barefoot on hard surfaces if that increases pain. Gentle movement is reasonable when comfortable, but return to running or jumping gradually after symptoms settle.

A clinician may suggest anti-inflammatory medication when it is safe with your health history. Persistent symptoms may prompt discussion of a cortisone injection. Joint aspiration is considered only when fluid needs removal or testing, such as when infection is suspected.

Seek prompt care for fever, spreading redness, drainage, rapidly increasing swelling, severe pain after an injury or inability to bear weight. Arrange an assessment if heel pain persists, changes your walking pattern, limits daily activity or does not improve after reducing pressure.

Ask: Is the bursa the source of pain, or could the plantar fascia or bone be involved? Which footwear and activities are suitable? Do I need imaging? Would medication, an injection or fluid testing be appropriate for my symptoms?