Synonym
achillodynia
Definition
An Achillodynia is a pain syndrome in the area of the Achilles tendon with an initially unclear cause, which can occur both at rest and under stress and can affect the normal physiological sequence of movement.
Occurrence
Achillodynia is a very common disease, especially in sports medicine and here especially in younger patients. Most patients are between the ages of 30 and 40 and have been doing sports up to 12 years when they first appeared. In the majority of cases, men are affected by the disease pattern. The reason is not known. The sport in which achillodynia most frequently occurs is athletics (78%).
Causes and forms
In the vast majority of cases, achillodynia is a syndrome associated with physical activity. Mostly affected are sports that require long or monotonous walking. Typical for an Achillodynia are movement-dependent pains in the area of the Achilles tendon about 2-6 cm above the heel.
The causes of an Achillodynia are mostly degenerative changes in the Achilles tendon. This is clearly shown, among other things, by vascular ingrowths and vascular neoplasms in the area of the Achilles tendon, which document the degeneration. Inflammatory changes in the area of the Achilles tendon, on the other hand, do not or only rarely occur.
Achillodynia is also a collective term for various symptoms (see symptoms). In many cases, the so-called Achilles tendon sliding tissue (paratenon) is also affected by the degenerative changes. The differential diagnosis of Achillodynia is the inflammation of the paratenon, which can lead to a movement-dependent grinding of the tendon.
In this case, inflammatory changes in the area of the Achilles tendon are often detectable. There are numerous differential diagnoses of an Achillodynia (see below), which can quickly be confused with an Achillodynia. In principle, a distinction is made between primary achillodynia and secondary achillodynia:
- Secondary Achillodynia: Secondary Achillodynia are circumstances or anatomical conditions that lead to additional strain on the Achilles tendon.
This additional load leads to the symptoms described above in the sense of an Achillodynia. Among the factors that put more strain on the Achilles tendon are: anatomical shortening, inflammation in the area of the gliding and bursae, previous fractures of the upper ankle joint or in the area of the tibia (shinbone), thickening of the Achilles tendon, calcifications in the area of the Achilles tendon and the gliding structures. – Primary Achillodynia:We speak of primary Achillodynia when none of the above mentioned risk factors are present and when the cause of the pain syndrome is unknown. The main cause of primary achillodynia is considered to be overloading during sporting activities. For this reason, the resulting treatment of primary achillodynia is accordingly limited.
