How To Treat Achilles tendinitis?

Tendinitis is usually treated with relatively simple interventions, but successful treatment requires patience and careful adherence to treatment guidelines. Your doctor is likely to recommend a combination of interventions for Achilles tendinitis:

- Self-care strategies
- Pain medications
- Stretching and exercises

Self-care strategies
Self-care includes the following steps, often known by the acronym R.I.C.E.:

- Rest. Rest is essential for tissue healing. Depending on the severity of your symptoms, resting may mean not exercising for several days; reducing the duration and intensity of your routine; or switching to an activity that doesn't strain the Achilles tendon, such as swimming. You may need to wear a walking boot and use crutches if you have significant pain when putting weight on your foot. Your doctor can advise you on what type of rest is appropriate for you.

- Ice. To decrease pain or swelling, apply an ice pack to the tendon for about 15 minutes after exercising or when you experience pain.

- Compression. Wraps or compressive elastic bandages can help reduce swelling and reduce movement of the tendon.

- Elevation. Raise the affected foot above the level of your heart to reduce swelling. Sleep with your affected foot elevated at night.

Pain medication
Your doctor is likely to recommend a prescription-strength or over-the-counter nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen (Advil, Motrin, others) or naproxen (Aleve, others) to reduce inflammation and relieve pain.

Long-term use of NSAIDs can cause stomach pain, stomach bleeding, ulcers and other side effects. Talk to your doctor about how long you should take your medication and how he or she will monitor you for side effects.

Stretching and exercise
Appropriate stretching and exercise can promote healing and prevent recurring problems. Your doctor can demonstrate the proper technique or refer you to a physical therapist or specialist in sports medicine. These techniques include:

- Stretching with knees straight. Lean against a wall with your knees straight and heels on the floor to stretch the upper portion of calf muscles.

- Stretching with knees bent. Place the foot forward and flex the knee and ankle with the heel flat on the floor to stretch the lower portion of calf muscles.

- Exercising calf muscles. Toe raises or the use of a calf-strengthening machine can help make the tendon stronger and treat Achilles tendon problems. A special type of strengthening called "eccentric" strengthening has been shown to be especially effective in treating chronic tendon problems. An example of this type of exercise to strengthen the calf muscle is slowly descending to the ground after rising on your toes.

Other treatments
Additional treatments may include the following:

- Orthotic devices protect or change the position of the foot and ankle in order to promote healing. A shoe insert or wedge that slightly elevates your heel can relieve strain on the tendon and provide a cushion that lessens the amount of force exerted on the tendon.

- Corticosteroid injections may be used with caution to reduce inflammation around a tendon that has been chronically inflamed. An increased risk of tendon rupture has been observed with this treatment. To lower that risk, your doctor may use ultrasound imaging to ensure that he or she injects the corticosteroid near the target site while avoiding a direct injection into the tendon.

- Platelet rich plasma (PRP) injection is a relatively new treatment under investigation for treating chronic, nonhealing degeneration of the Achilles tendon (Achilles tendinosis) and other chronic tendon problems. This treatment involves injecting your own blood plasma, which contains factors that promote healing, at the site of the inflamed tendon.

- Surgery to repair damaged tissue and improve function of the tendon is considered only when several months of more conservative treatments don't work or if ongoing inflammation results in partial or complete rupture of the tendon.