What is the best treatment for a chronic Achilles tendinopathy?
In a recent article by Uquillas et al suggest that the best treatment for tendon injuries to the Achilles are conservative. They suggest that the best thing to do is rest, ice, and compression. There is also need for activity modification, as the likely cause of injury is overuse. Often a heel lift is prescribed to decrease pain and stress to the injured tendon. Occasionally a night splint to improve flexibility is helpful. NSAIDS may also be prescribed to decrease pain. To regain strength a course of eccentric strengthening has also been shown effective. Brisement, which is when a dilute anesthetic in injected into the tendon sheath, has also been shown to b helpful. Surgical treatment is usually reserved for a last resort when conservative treatments have failed and involves scraping away the thickened and inflamed tissue around the tendon or its attachment. The authors do not recommend using corticosteroid shot for treatment because there is no good evidence to show that it speeds recover and that in fact it is associated with potential compromise of the tendon integrity. Your physician may be able to guide you in these steps, or often a Physical Therapist will also be able to provide this conservative treatment.
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