Achilles Tendonitis: What Are Therapy & Treatment Options For Heel Pain?

What Is Achilles Tendonitis

Achilles tendonitis is when the tendon behind the heel, which joins the heel bone to the calf muscle, becomes inflamed. This tendon aids in daily mobility activities such as walking, running, climbing, and jumping. Tendonitis occurs when there is an associated injury or disease or even with overuse or degeneration. The pain can be excruciating and may lead to long-term and chronic health issues.

Associated symptoms

Besides feeling heel pain, Achilles tendonitis is accompanied by other symptoms. A patient can also feel pain in the ankle, tendon and swelling of the tendon, and weakness of the leg. The symptoms are apparent after a long day of activity or exercise and exacerbate throughout the day. If a sudden pop is felt behind the calf or heel, there is a possibility of a ruptured tendon. A ruptured tendon requires a doctor’s immediate attention and care.

Types of Achilles tendonitis

There are two types of Achilles tendonitis depending on which area of the tendon is affected. The two types include non insertional Achilles tendonitis and insertional Achilles tendonitis. Noninsertional Achilles tendonitis occurs when the middle part of the tendon is swollen and degenerated. Insertional Achilles tendonitis impacts the lower part of the tendon that joins the heel bone. Noninsertional tendonitis occurs in younger, active people whereas insertional tendonitis affects any age group and also inactive people.

Therapy and treatment options

The treatment of Achilles tendonitis for each patient varies depending on the severity. The treatment options are classified as either conservative or surgical treatment. When the treatment begins, the effect of treatment may take a few months or up to 6 months. If conservative treatments do not work after 6 months, the doctor will recommend surgical options.

Conservative treatment methods

A common option is REST which represents rest, ice, elevation, and compression. Other non-invasive options include supportive shoes, physical therapy, eccentric training, laser therapy, and prolotherapy. Medications such as non-steroidal anti-inflammatory drugs (NSAIDs) and steroids may also help. More conservative treatment options include extracorporeal shock wave therapy and platelet-rich plasma (PRP) treatment.

Surgical treatment methods

In some patient cases, conservative treatment options may not be effective and the doctor may recommend surgical therapies. Some surgical options include percutaneous longitudinal tenotomy, minimally invasive tendon stripping, tendon debridement and repair. The recovery outcome is usually good post-surgery, but some patients may take longer to recuperate.

When happens post-surgery

After surgery, physical therapy is usually recommended for a year for patients to be pain-free. A common complication is a patient may experience moderate to severe pain, which will subside eventually. Some patients may experience infection, which is not easy to treat. The doctor will advise the best treatment option depending on the severity and answer any concerns or questions.