Non-Surgical Achilles Tendonitis Treatment in Raleigh, NC
Achilles tendonitis is inflammation and/or degeneration of the Achilles tendon. At Wake Non Surgical Ortho, Dr. Matthew Kanaan provides non-surgical treatment options to patients suffering from Achilles tendonitis. Dr. Kanaan will take the time to provide you with a proper diagnosis to determine the best treatment option for you. For more information, contact our orthopedic clinic in Raleigh at (919)719-2270 and schedule your appointment today!
What Causes Achilles Tendonitis?
Most injuries of the Achilles tendon are overuse conditions caused by repetitive motion associated with poor biomechanics. Improper footwear, improper warm up, inflexibility of the calf muscles, and improper cool down are factors that increase the chance of Achilles tendonitis.
How Does Dr. Kanaan Diagnose Achilles Tendonitis?
Diagnosis of Achilles tendonitis includes patient history, physical examination and sometimes imaging tests. Physical examination findings include palpation for tenderness, swelling, nodules, warmth, and increased width of the tendon. Imaging tests that may help diagnosis Achilles tendonitis include: x-ray, ultrasound, and MRI. Ultrasound is the most reliable in determining the thickness of the Achilles tendon and is most convenient as it can be performed during the patient encounter.
Non Surgical Achilles Tendonitis Treatment Options
SHOCKWAVE
A systematic review and meta-analysis demonstrated that shockwave therapy for insertional Achilles tendinopathy is an effective treatment modality (Al-Abbad and Simon, 2013). A randomised controlled trial (RCT) of 50 patients (Rompe et al., 2008) compared shockwave with eccentric exercises. The study found statistically significant improvement for outcomes of pain and function at 4-month follow-up in the shockwave group.
A large case-control study (Furia, 2006) consisting of 68 patients compared shockwave with conservative treatment including rest, footwear modification, anti-inflammatory medication, gastrocnemius-soleus stretching and strengthening (n=34). The study demonstrated shockwave was statistically significantly better in improving pain. In fact, an average pain reduction of 5 on a 10 point visual analogue scale (VAS) was experienced by the patients i.e. this is a minimum of 50% pain reduction.
It is concluded that shockwave therapy is more effective than physiotherapy and rehabilitation alone for insertional Achilles tendinopathy. In one study, the more sports-active patients had better clinical outcomes than non sports-active patients after 5 years of follow-up (Zhang et al., 2020). This study also showed that following a course of shockwave therapy the symptoms continue to improve for several years afterwards. Furthermore, there was a very low reoccurrence rate in the shockwave group. This is particularly important because Achilles problems have a high reoccurrence rate.
WALKING BOOTS
Walking boots can be used in initially to limit the motion of the Achilles in severe cases, and allow healing. However there should be periods of time out of the boot to allow for range of motion exercises, otherwise the ankle will get very stiff in a short amount of time.
PROLOTHERAPY
Prolotherapy, or “proliferation therapy”, is a term that is generally used to describe various injections which act to strengthen weakened degenerative connective tissue by an irritant effect. They are mostly used at insertions of tendons or ligaments. The types of solutions vary but commonly used injection types include glucose, local anesthetics such as lidocaine, phenol, or glycerine. The evidence for prolotherapy is fairly mixed, but some patients do tend to see improvement, particularly in chronic cases.
PRP INJECTIONS
The evidence for the use of autologous blood products, including platelet rich plasma (PRP), to treat Achilles tendinopathy or other tendinopathies is pretty good. Overall most patients seem to do well with PRP injections combined with rest.
Here is a good study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7298400/
Corticosteroids
Corticosteroids are NOT advised near the achilles tendon for risk of rupture
Schedule an Appointment for Achilles Tendonitis Treatment in Raleigh, NC
Don’t wait! Call our orthopedic clinic in Raleigh at (919)719-2270 today to experience knee pain relief without the risk of surgery.