Achilles Tendon Pain (Achillodynia)

Achillodynia is the medical term for chronic pain in the Achilles tendon. The condition is caused by overuse (e.g. competitive sports), foot deformities, injuries, and certain medications (cortisone). Characteristically, the problem starts as pain occurring during exercise or sports activities, with the pain being localised in the area where the Achilles tendon attaches to the heel bone. As the condition progresses, the pain is felt even during rest and the tendon area become hot and swollen.

Diagnosis

The physical examination generally reveals localised pain and, in some cases, a palpable bump at the site where the Achilles tendon attaches to the heel bone. Diagnostic options consist of ultrasound (sonography), plain radiographs (X-ray) to check for signs of tendon calcification, and magnetic resonance imaging (MRI) for a more precise assessment of anatomic structures.

Treatment

As a rule, conservative treatment is attempted first. Conservative treatment measures include shoe modification, ice, heat, physiotherapy (calf muscle stretching exercises), and medications to reduce pain and inflammation. If all conservative measures fail to relieve the symptoms, then surgical treatment is performed. The surgery is performed through a small incision made in the skin directly over the Achilles tendon. The irritated, inflamed and necrotic (dead) tissues are removed. After surgery, early functional mobilisation will be initiated. This means that physiotherapy is started in the early postoperative phase in order to prevent tissue adhesion and to achieve full recovery of the tendon.