Numerous conditions may cause posterior heel pain. According to the American Academy of Orthopaedic Surgeons, or AAOS, one of the most common causes of posterior heel pain is ill-fitting shoes. Another common cause of posterior heel pain is injury from overuse, which often occurs among runners. Certain medical conditions may also cause posterior heel pain. Most cases respond well to conservative care methods, such as shoe therapy, manual therapies and physical therapy.
Bursitis
Bursitis can cause posterior heel pain. According to the MedlinePlus website, bursitis--retrocalcaneal bursitis, specifically--is swelling or inflammation of the bursa at the back of the heel, between the Achilles tendon and the heel bone or calcaneus. A bursa is a jelly-like sac situated between a tendon or ligament and bone. Bursae, which are found throughout the body, help reduce the amount of friction between these tissues during movement. The most common cause of retrocalcaneal bursitis, according to MedlinePlus, is repetitive use of the ankle. Excessive walking, running or jumping can contribute to retrocalcaneal bursitis. Common signs and symptoms associated with retrocalcaneal bursitis include posterior heel pain made worse by activity, posterior heel pain when standing on tiptoes, and an inflamed area over the back of the heel. A person who starts an aggressive exercise program without proper conditioning is particularly susceptible to retrocalcaneal bursitis.
Blisters
The Sports Injury Clinic states that blisters are friction burns caused by shoes or clothing that rub repeatedly on the skin. These blisters can cause posterior heel pain. As the outer layer of skin separates from the underlying tissue, the space created between the layers fills with lymph fluid, creating a spongy or boggy area at the injury site. According to the Sports Injury Clinic, blisters are particularly common among athletes wearing new shoes and athletes participating in endurance events. Common signs and symptoms associated with posterior heel blisters include redness over the back of the heel, a bubble of skin filled with clear fluid, posterior heel pain and itching. Posterior heel blisters vary in size. The Sports Injury Clinic states that most blisters can be prevented by taking necessary precautions before activity.
Reactive Arthritis
Reactive arthritis can cause posterior heel pain. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, or NIAMS, reactive arthritis, also known as Reiter's syndrome, is a type of arthritis or joint inflammation caused by a reaction to an infection in another part of the body. Reactive arthritis typically manifests approximately one to three weeks following infection. The most common infectious agent to cause reactive arthritis is chlamydia trachomatis, or simply chlamydia. Reactive arthritis produces symptoms throughout the body, including the urogenital tract, bones, joints and eyes. Common bone- and joint-related signs and symptoms associated with reactive arthritis include pain and swelling in the knees, ankles and feet; Achilles tendinitis or inflammation of the Achilles tendon at the back of the heel; and heel spurs or osteophytes. According to the NIAMS, most people with reactive arthritis make a full recovery following the onset of symptoms, returning to their usual activities within two to six months after the first symptoms manifest.
