Achilles Tendinitis: Causes, Symptoms, Treatment and Cost

Achilles Tendinitis is a painful ailment that occurs when the Achilles tendon, which links the calf muscle to the heel bone, gets inflamed.

There are three types of Achilles tendinitis: non-insertional, insertional and paratenonitis.

• Non-insertional Achilles tendinitis: Non-insertional Achilles tendinitis is caused when the fibers of the tendon become inflamed due to excessive strain or overuse.
• Insertional Achilles tendinitis: Insertional Achilles tendinitis occurs when inflammation occurs at either end of the tendon where it attaches to bone in either the heel canal or calcaneus (heel bone).
• Paratenonitis: Paratenonitis is an inflammation that occurs between layers of tissue surrounding your Achilles tendon (the paratenon).

Overuse or abrupt pressure on the Achilles tendon causes Achilles tendinitis.

Other causes of Achilles tendinitis include tight calf muscles, inappropriate footwear, or a change in terrain or running surface.

• Pain and tenderness in the back of the heel and lower calf
• Trouble with weight-bearing tasks such as walking, jogging, and climbing stairs.
• Swelling and stiffness in the affected area.
• Creaking or cracking sound when moving or touching ankle joint.
• Morning stiffness which relieves with movement.

• Stretch, strengthen and warm up your calf muscles regularly.
• Wear comfortable, well-cushioned footwear with arch support.
• Avoid activities that involve sudden stops and starts or jumping, such as basketball and tennis.
• Avoid running on hard surfaces or uphill for long distances.
• Increase your activity level gradually over time to avoid overuse injuries of the Achilles tendon

• Physical examination: A healthcare provider will typically begin by performing a physical examination of the affected area, including palpation (feeling the area with their hands) and range of motion tests to assess the severity of the inflammation and the extent of any pain or tenderness.
• Imaging tests: An X-ray or MRI can help to rule out other potential causes of pain and discomfort, such as a bone spur or a tear in the tendon.
• Ultrasound: This test uses sound waves to create an image of the tendon and can be used to evaluate the extent of inflammation or damage to the tendon.
• Blood tests: Blood tests may be ordered to check for signs of an underlying condition that could be contributing to the development of Achilles tendinitis, such as rheumatoid arthritis or gout.
• Injection Tests: A healthcare provider may inject a small amount of a local anesthetic into the area around the tendon to help determine if the pain is coming from the Achilles tendon or from another source, such as a nerve.

• Inflammation and pain in the heel, ankle, and calf.
• Swelling of the Achilles tendon area.
• Thickening of the tendon due to degeneration or overuse.
• Limited range of motion and difficulty bearing weight on the affected leg.
• Stiffness and weakness in the ankle joint and surrounding muscles, leading to instability or imbalance in gait pattern when walking.
• Scar tissue formation that can lead to a weakening of the Achilles tendon and further injury/tear if not treated properly or promptly.

• Oil: Apply a warm compress or a hot bottle of water to the afflicted region for fifteen to twenty minutes at a time, many times each day.
• Herbs: Eat anti-inflammatory foods such as ginger, turmeric, garlic, and cayenne pepper to reduce inflammation in the affected area.
• Water: Consuming a sufficient amount of water during the day may benefit in the removal of contaminants from the body as well as the reduction of inflammation in the tendons and muscles.

• Consume a diet that is nutritious and has the appropriate amounts of protein, carbs, and good fats.
• Include anti-inflammatory foods such as fatty fish, berries, dark leafy greens, and turmeric.
• Increase intake of vitamins A, C and E for improved antioxidant protection and healing of tendons.
• Increase intake of minerals such as zinc, magnesium and selenium to help reduce inflammation and rebuild tendon tissue damage faster.

• Cut down on processed foods like canned, frozen, and pre-made meals as much as you can.
• Avoid saturated fats found in full-fat dairy, red meats and fried foods.
• Cut down on sugar intake from carbonated beverages, sweets and desserts.
• Limit consumption of caffeine from coffee, tea and energy drinks.
• Avoid alcohol consumption as it can increase inflammation in the body.

• Rest: It is advised that you take some time off from activities that bring you pain.
• Ice: In order to minimise swelling, use ice packs for 15 minutes every three to four hours.
• Compression: A compression bandage, when worn, may be helpful in reducing swelling as well as inflammation.
• Elevation: Keeping the affected area elevated on a pillow helps to reduce swelling and inflammation too.
• Stretching & Strengthening Exercises: These exercises help increase flexibility, range of motion, strength, and coordination of the foot and ankle muscles.
• Orthotics: Custom-made orthotics may help redistribute pressure away from the inflamed tendon area and take stress off the Achilles tendon when walking or running.
• Anti-inflammatory Medication: Anti-inflammatory drugs may relieve pain and inflammation.
• Open debridement surgery: Open debridement is the most common surgical treatment and involves removing scar tissue, adhesions, and inflamed tissue from the tendon sheath.
• Tenotomy: Tenotomy involves cutting a portion of the Achilles tendon to reduce pressure on it, while tendon transfer involves re-routing another tendon to take over the function of the Achilles tendon.

• To treat this condition, it is best to consult an orthopedics doctor or a sports medicine specialist.
• These doctors can provide treatments such as physical therapy, medications, and specialized exercises to reduce pain and inflammation in the Achilles tendon.

• Non-steroidal anti-inflammatory drugs (NSAIDs): These help to decrease inflammation, swelling, and pain. Examples include ibuprofen and naproxen.
• Physical therapy: Exercises that help with range of motion, flexibility, and strength can be beneficial in treating Achilles tendinitis.
• Steroid injections: Corticosteroid injections may provide relief and reduce inflammation in severe cases.
• Orthotics: Custom-made shoe inserts can help support the foot and ankle to relieve stress on the tendon.
• Platelet Rich Plasma (PRP): Injections of a person's own blood plasma enriched with platelets may provide relief from Achilles tendinitis symptoms.

Typically, complete healing might take somewhere from several weeks to several months.

• In general, treatments may alleviate symptoms and enhance function in the afflicted region.
• However, it is essential to realise that these treatments may not be lasting solutions.
• Some cases may require surgery to fully resolve the issue.

• After treatment, it is important to follow a rehabilitation program that focuses on stretching, strengthening and endurance exercises to help the Achilles tendon heal.
• Resting and minimizing activities that exert pressure on the afflicted region are necessary for the tendon to recover properly.
• Ice therapy can be applied to reduce inflammation and pain associated with Achilles tendinitis.
• Wearing appropriate footwear with good support can help reduce the risk of developing Achilles tendinitis or re-aggravating an existing injury.
• Stretching and strength exercises should be done on a daily basis as part of a rehabilitation programme after treatment for Achilles tendinitis.

The price of medical treatment might be anything from a few hundred to several thousand Indian rupees depending on the chosen treatment strategy.

• The most common side effects of treatment for Achilles tendinitis include pain, swelling, and stiffness in the affected area.
• Other possible side effects may include infection, bleeding, or nerve damage if the treatment involves surgery.
• Physical therapy and rehabilitation exercises can also cause soreness and muscle fatigue.

If you are suffering from any complications relating to Achilles tendinitis then you should consult a doctor nearby as they can cause complications like 'Chronic pain, Tendon rupture, Scarring and calcification' in which treatment courses can range from a few months to years depending on the severity of the situation.