What bursitis is
Bursae sit at points where tendons, muscles or skin glide over bone. Repeated pressure, friction or overload can inflame a bursa, which then fills with more fluid and becomes painful. In the foot, tight or rigid footwear is a major factor.
See also hip bursitis and shoulder bursitis.
Retrocalcaneal bursitis (back of the heel)
This affects the bursa between the Achilles tendon and the heel bone. Pain is felt just above the heel, at the back, and worsens with walking, running uphill, rising on tiptoes and when starting to move after rest. It often occurs alongside Achilles tendon problems.
See heel pain.
Superficial heel bursitis and Haglund’s deformity
A bursa between the skin and the Achilles tendon can become inflamed from rubbing by stiff shoe backs, causing a red, tender bump, sometimes called a “pump bump”. A bony enlargement of the heel, Haglund’s deformity, increases pressure. Shoes with soft, low backs help.
See heel spur.
Bursitis in the ball of the foot
Bursae under the heads of the metatarsal bones can become inflamed, causing pain in the ball of the foot, sometimes with a feeling of walking on a pebble. High heels, thin soles, high-impact sports and loss of the fat pad with age are risk factors. It can coexist with Morton’s neuroma.
See Morton’s neuroma.
Bunion bursitis
A bursa can form over the bony bump of a bunion at the base of the big toe. Pressure from shoes makes it red, swollen and painful. Wider shoes and padding reduce pressure.
See bunion and big toe pain.
Symptoms
- Pain, especially when walking, running or wearing shoes.
- Swelling and a soft lump.
- Tenderness to touch.
- Warmth and redness, especially with superficial bursitis.
- Stiffness after rest.
Causes and risk factors
- Shoes with stiff heel counters, high heels or narrow toe boxes.
- A sudden increase in running, walking or jumping.
- Tight calf muscles.
- Foot shapes such as Haglund’s deformity, bunions and high arches.
- Inflammatory arthritis and gout.
- Infection, rarely, after a cut or skin break.
Diagnosis
Diagnosis is based on symptoms and examination. Ultrasound can show the inflamed bursa and check the Achilles tendon; X-rays may show a Haglund’s deformity, bunion or spurs. If infection or gout is suspected, fluid may be drawn and tested.
Home treatment
- Reduce aggravating activities for a while.
- Ice wrapped in a cloth for 15 to 20 minutes several times a day.
- Shoes with soft backs, cushioned soles and wide toe boxes.
- A heel lift or open-backed shoes for heel bursitis.
- Gel pads or metatarsal pads to offload pressure.
- Simple painkillers if appropriate.
Exercises
- Calf stretches: against a wall with the knee straight and bent.
- Towel curls and toe spreading for the small foot muscles.
- Calf raises on a flat surface, progressing gradually.
- Ankle mobility exercises.
For retrocalcaneal bursitis, avoid deep stretches that compress the back of the heel and avoid calf raises off a step at first. See flat feet exercises.
Medical treatment
If symptoms persist, a podiatrist or physiotherapist may provide insoles, padding or shockwave therapy. Steroid injections may help some types but are used cautiously near the Achilles tendon because of the risk of rupture. Surgery is rare, for example removing a Haglund’s deformity or correcting a bunion when other treatments fail.
Septic bursitis
An infected bursa becomes very red, hot, swollen and painful, sometimes with fever. It needs prompt medical treatment with antibiotics and sometimes drainage.
When to see a doctor
- Redness, heat and fever.
- Severe pain or swelling.
- Pain that does not improve after 2 weeks of self-care.
- A sudden snap or pain at the back of the heel, possibly an Achilles tendon rupture.
- Diabetes with a foot wound or swelling.
Key points to remember
- Foot bursitis affects the heel, ball of foot or big toe.
- Pressure from shoes and overuse are the main causes.
- Shoe changes, ice, padding and exercise help most cases.
- Red, hot swelling with fever needs urgent care.
Questions about foot bursitis
These answers are general information and do not replace an examination or individual medical advice.
How long does foot bursitis take to heal?
Most cases improve within a few weeks with rest and shoe changes.
What does heel bursitis feel like?
Pain and swelling at the back of the heel, worse with walking and tight shoes.
Should I walk with foot bursitis?
Yes, within comfort, with supportive, soft-backed shoes.
Is ice or heat better for bursitis?
Ice helps reduce pain and swelling in the early stages.
What shoes are best for heel bursitis?
Shoes with soft, low backs, cushioning and a slight heel lift.
Can bursitis in the foot go away on its own?
It often settles once pressure is removed.
Is foot bursitis the same as plantar fasciitis?
No. Plantar fasciitis affects the sole of the heel; bursitis is usually at the back.
Can gout cause foot bursitis?
Yes, gout and inflammatory arthritis can inflame bursae.
Do insoles help foot bursitis?
They can redistribute pressure, especially in the ball of the foot.
Sources
This guide is for general information and does not replace medical advice. How a problem is diagnosed and treated depends on your examination and medical history. If you think you have an emergency, contact your local emergency services.