Pain at the back of your heel, visible swelling, and stiff-backed shoes you can no longer wear? That is the typical picture of heel bursitis — an inflammation often confused with Achilles tendinitis or plantar fasciitis, yet treated differently. Which is exactly why an accurate diagnosis matters.
What is heel bursitis?
Your heel has two bursae — small fluid cushions that reduce friction: the retrocalcaneal bursa, between the heel bone and the Achilles tendon, and a superficial bursa between the tendon and the skin. When either becomes irritated through friction, pressure or overload, pain appears at the back of the heel, often with visible swelling.
Common symptoms
Pain at the back of the heel, worse with walking, running or climbing; local swelling and redness; tenderness to pressure; pain when wearing shoes with a rigid heel counter; and morning stiffness around the Achilles tendon.
Common causes
Repeated friction from rigid or ill-fitting footwear, sudden increases in running or walking volume, a short and stiff Achilles tendon, a Haglund deformity (bony prominence of the heel), inefficient gait mechanics and — less commonly — systemic inflammatory conditions.
Can it be treated without surgery?
Yes, in the vast majority of cases. Heel bursitis responds well to conservative care: reducing pressure and friction, releasing the Achilles chain, and correcting the mechanical cause. Surgery is considered only in chronic cases with significant bony deformity.
How we treat heel bursitis at Medicine Park
After assessing your heel, Achilles tendon and gait, your plan may include manual therapy and stretching for the posterior chain, dry needling for calf trigger points, progressive loading exercises, and footwear and training adjustments. We clearly differentiate bursitis from Achilles tendinopathy and other causes of posterior heel pain, so treatment targets exactly the right structure.
How long does recovery take?
Recent cases usually settle in 2–4 weeks. Chronic bursitis — especially with a Haglund deformity or a stiff Achilles — may need 6–8 weeks of a complete programme.
When to seek help
If pain at the back of your heel persists, the swelling is growing, or comfortable shoes are getting hard to find — book an assessment. Your first assessment at Medicine Park is free.
