Achilles tendonitis pain may vary in intensity depending on the extent of the inflammation in the tendon. Pain is typically felt at the heel (where the tendon attaches) and along the length of the Achilles tendon (extending from the back of your leg to the heel). It may be particularly severe when walking or running, although pain may also exist when touching along the tendon.
Pain and stiffness are generally more severe in the morning. Often, there is swelling and warmth in the heel or along the tendon. The affected person may find it difficult to stand on their toes or move their foot up and down. The heel pain may even cause discomfort when wearing shoes.
What is Achilles tendonitis?
Achilles tendonitis is the inflammation of the Achilles tendon (a fibrous band that connects the muscles of the back of your leg to your heel bone). This tendon typically becomes swollen and painful near the bottom of the foot.
The Achilles tendon plays an essential role while you walk, run or jump. These movements require the action of the calf muscles that the Achilles tendon connects to the heel. The muscles and tendon together allow you to push your heel off the ground when you stand up on your toes.
Achilles tendonitis most commonly occurs due to overuse, especially in young people. Athletes, including runners and walkers, are more prone to this condition. Although rare, injuries may also cause Achilles tendonitis.
In middle-aged and older adults, Achilles tendonitis more commonly occurs due to arthritis. The development of bone deformities, such as a bone spur or growth, at the back of the heel bone may cause tendonitis by irritating the Achilles tendon. There is some evidence pointing to vitamin D deficiency as a cause of Achilles tendinitis; however, the findings from these studies are mixed.
How is Achilles tendonitis treated?
Achilles tendonitis is generally treated with lifestyle changes and medications. Symptoms may take at least two to three months to go away.
You can better help your Achilles tendon recover faster through these tips:
- Apply ice to the Achilles tendon area for 15 to 20 minutes to decrease inflammation. Repeat this two to three times a day.
- Get adequate rest and avoid activities that cause more pain. You may try low-impact activities such as swimming, biking or walking on softer and smoother surfaces.
- Perform stretching exercises for the Achilles tendon as advised by your provider or physiotherapist.
- Keep the affected leg elevated to reduce swelling.
- Avoid walking up steep inclines or standing on a ladder rung.
- Avoid walking barefoot.
- Use supportive shoes with heel cushions or heel lifts.
- Use a brace, boot or cast to keep the heel and tendon still and allow the swelling to subside.
- Take over-the-counter (OTC) medications such as aspirin or ibuprofen to relieve swelling and pain. However, do not give aspirin to children or teens as it may be harmful.
Your healthcare provider may also suggest muscle-strengthening exercises, stretching, running re-education and lifestyle changes for maintaining a healthy weight. They may prescribe alternative treatment options such as massages and extracorporeal shock wave therapy (ESWT) that uses sound waves to relieve symptoms and reduce inflammation.
Generally, surgery is not required. However, if the symptoms do not get better with conservative treatment, you may need surgery to remove the inflamed tissue and abnormal areas of the tendon. Surgery may also be needed if there are bony abnormalities such as bone growth or spur.
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