The therapy of Achilles tendonitis is difficult. Even in ancient times, the Achilles heel was a weak point. Even today the treatment of the Achilles tendon is one of the most difficult therapies in orthopaedics. For this reason, the treatment should be carried out as early as possible to avoid a chronicity of the inflammation.
Overview of therapy options
The following treatment options are available to treat acute Achilles tendonitis: As a long-term therapy option for the prevention of an aggravation of the inflammation or in case of already existing chronic inflammation:
- Painkillers (including anti-inflammatory drugs such as ibuprofen or aspirin)
- Heel wedges
- Cortisone injections
- Tape bandages with kinesiotape
- Laser therapy
- Ultrasound therapy
Acute measures for self-therapy
There are a number of methods for treating Achilles tendonitis that anyone affected can carry out themselves without having to see a doctor. However, one of the simplest methods of therapy for Achilles tendonitis is always to reduce the amount of training. Movements that cause the pain should be avoided, but the foot should also not be completely immobilised.
But also special Achilles tendon bandages relieve the heel by an integrated wedge. This is particularly recommended in the acute stage of Achilles tendonitis for short-term reduction of pain and swelling. – Immobilizing the foot (in the sense of a sports break)
- Heel elevation
Cold therapy is a very important therapeutic tool, especially at the beginning, i.e. in the acute phase of Achilles tendon inflammation.
Such an inflammation is usually characterized by pain, redness, overheating, swelling and a limited function of the tendon. Especially the redness and overheating can be reduced by means of cold therapy. This also reduces pain, which improves functionality. Cold can be applied to the Achilles tendon in the form of an ice pack or a cooling pack. However, these should be covered with a thin cloth or towel so that the skin is not damaged by the cold.
The therapy of an Achilles tendon inflammation is usually performed conservatively, i.e. with medication. Surgery is only performed in very rare cases of Achilles tendonitis. Usually, the inflammation can be completely cured by taking certain medications in conjunction with sparing the tendon.
The conservative therapy of Achilles tendon inflammation is mainly based on a specific group of substances that have both a pain and an anti-inflammatory function. The so-called NSAIDs (non-steriodal anti-inflammatory drug) such as acetylsalicylic acid, ibuprofen and diclofenac help the affected patients in two ways. Since severe pain can occur in the case of Achilles tendonitis, it is usually necessary to take painkillers in the acute phase of the disease.
At the same time, the drugs can have an active influence on the healing process of the Achilles tendon through their anti-inflammatory effect. It should be noted here that the drugs do not contain cortisone and thus the typical side effects of cortisone-containing anti-inflammatory drugs do not occur here. Especially drugs with the active ingredients ibuprofen and diclofenac are well suited for the conservative treatment of Achilles tendon inflammation.
Other drugs that have an effect on the healing of Achilles tendon inflammation are anti-inflammatory drugs containing the active ingredient cortisone. Since a therapy with cortisone is usually accompanied by side effects, this is only considered in cases of severe disease progression. Depending on the course of healing, injections of cortisone may even be necessary to control the inflammation of the tendon.
In general, the therapy of an Achilles tendon inflammation is best carried out in consultation with the treating doctor. This is especially true when pain is present. The doctor can best assess the individual clinical picture and the appropriate therapy.
Among other therapies, the application of certain ointments is a popular method of treating Achilles tendonitis. The actual effect of applying ointments in the case of Achilles tendonitis is highly controversial. Due to the evaporation of the ointment on the skin, each ointment that is applied has a cooling effect on the corresponding area.
Ointments containing active agents frequently contain anti-inflammatory substances like ibuprofen or diclofenac. It has to be considered that the active agents do not only act at the appropriate place but are first absorbed by the skin and distributed throughout the whole circulation. Thus, only a very small part of the active ingredient can actually act on the Achilles tendon.
It is better to take medication in tablet form as the dose can be estimated much better with this form of administration. Other ointments without chemically produced active ingredients, such as tea tree oil, horse ointment or arnica ointment, have, like any ointment, a cooling effect at the appropriate place. A healing effect beyond this has not yet been scientifically proven with these ointments and is therefore highly controversial. In summary, a sole therapy of an Achilles tendon inflammation should not take place exclusively by applying ointments, but instead a suitable, individual therapy should be discussed with the treating physician.