What are the diagnosis and treatment for Achilles tendinitis and bursitis with bone spurring?

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Understanding Your Left Heel Condition

Your ultrasound findings show mild left Achilles tendinitis, mild retrocalcaneal bursitis, and moderate bone spurring where your Achilles tendon attaches to your heel bone. This combination of issues is causing your heel pain and requires appropriate treatment to prevent worsening of symptoms and promote healing.

What These Findings Mean in Simple Terms

  • Moderate dorsal calcaneal spurring: You have moderate bone spurs on the back of your heel bone where the Achilles tendon attaches 1
  • Thickened left Achilles tendon: Your left Achilles tendon is about twice as thick as your right one (6mm vs 3mm), indicating inflammation 1
  • Increased fluid in retrocalcaneal bursa: The small fluid-filled sac between your heel bone and Achilles tendon has more fluid than normal, indicating inflammation (bursitis) 1
  • No tears or calcification: Fortunately, there are no tears or calcium deposits in the tendon, which would indicate more severe damage 1

Treatment Recommendations

Immediate Steps

  • Reduce pressure on the area: Wear open-backed shoes to decrease pressure on the inflamed area 1
  • Use heel lifts or orthotic devices: These help reduce tension on the Achilles tendon 1
  • Take anti-inflammatory medication: NSAIDs like naproxen can help reduce pain and inflammation 2
  • Apply ice: Use ice through a wet towel for 10-minute periods to reduce inflammation 1
  • Limit activities: Avoid activities that worsen your pain, but complete rest is not necessary 1

Important Caution

  • Avoid corticosteroid injections into the Achilles tendon: These are NOT recommended for Achilles tendinitis as they may weaken the tendon and increase risk of rupture 1, 3
  • For the bursitis component only: Corticosteroid injections may be considered but must carefully avoid the Achilles tendon itself 1

Ongoing Treatment (6-8 weeks)

  • Regular stretching exercises: Perform calf muscle and Achilles tendon stretching exercises daily 1
  • Gradually modify activities: Slowly return to normal activities as pain allows 1, 4
  • Weight loss: If overweight, losing weight can reduce stress on the tendon 1
  • Physical therapy: May help with proper stretching techniques and strengthening exercises 1, 5

If No Improvement After 6-8 Weeks

  • Seek specialist referral: Consult with a podiatric foot and ankle surgeon 1
  • Consider immobilization: A walking boot or cast may be recommended for more stubborn cases 1
  • Advanced imaging: MRI may be needed to assess the condition more thoroughly 1, 5

Surgery (Only if Conservative Treatment Fails)

  • For persistent bursitis with bone spurs: Surgical removal of the prominent bone spur and inflamed bursa may be considered 1, 6
  • For chronic tendinitis: Debridement of damaged tendon tissue may be necessary 5, 6

Expected Recovery

Most patients with this combination of conditions respond well to conservative treatment within 6-8 weeks 1, 4. However, recovery may be prolonged in some cases, especially with bone spurring. The good news is that you don't have any tendon tears, which generally means a better prognosis with appropriate treatment 4, 5.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Four common types of bursitis: diagnosis and management.

The Journal of the American Academy of Orthopaedic Surgeons, 2011

Research

Achilles tendon disorders.

The Medical clinics of North America, 2014

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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