A cortisone injection into the bursa is one other option to treat calcaneal bursitis. However, cortisone weakens tendons and the bursa causing your pain is exactly where your Achilles tendon inserts into your heel bone. This means that an injection into the bursa will increase your risk of an Achilles tendon rupture.
Topical creams or muscle rubs
Your swollen heel bursa will be very sensitive to direct pressure, so rubbing creams on the back of your heel will be quite painful. The pain from bursitis is caused by increased pressure due to swelling inside the bursa. Massage or creams on the outside of your heel will have no effect on this pressure, so it will not help to get rid of your pain.
Orthotist or podiatrist
Orthotics or inner soles can help with treatment of calcaneal bursitis, especially if you have high foot arches or flat feet (overpronation). An orthotist or podiatrist can assess your foot and make these orthotics if necessary.
Silicone inserts or heel cups in your shoes can also help managing your heel pain. The silicone helps with shock absorption, taking some of the pressure off of the inflamed bursa.
Braces, bandages and splints
Using a brace or bandage to block ankle movements may give you temporary relief. Friction over your calcaneal bursa is what led to the swelling and increased pressure. In theory, this should mean that stopping movement i.e. friction should solve the problem? Unfortunately, if you don’t solve the underlying problems like muscle tightness and incorrect biomechanics, your heel pain will be back in full force as soon as you remove the brace or bandage.
This is when a needle is inserted into the bursa to remove fluid and reduce the pressure. With any invasive procedure there’s always a risk of infection, so this should not be your first treatment option.
Your GP can prescribe medication to help with inflammation and pain. Topical medication (like patches or ointment) can always help with pain relief and swelling.
A controversial treatment for heel bursitis is shockwave therapy. In theory the high energy shockwaves can speed up the healing process. However, this technique feels like strong pulses directly over the painful bursa and can be extremely painful.
For long-term management and strengthening we might refer you to a biokineticist after completing physiotherapy treatment for your heel pain.