When Achilles tendon pain won’t go away, it could be because you’re treating the wrong cause of that discomfort. You see, there two distinct conditions that could lead to chronic discomfort in this area: Achilles tendinitis and Achilles tendinosis. In this post, we explain each condition, highlighting key differences to help you obtain the right diagnosis and treatment plan.
What’s Causing Achilles Tendon Pain: Tendinitis or Tendinosis![Woman grabbing her Achilles tendon]()
First let’s clearly define each condition. Tendinitis describes inflammation; it typically develops within the first few days or weeks of an injury, and you tendon becomes inflamed, swollen and painful. However, the actual structure of the tendon remains intact.
With tendinosis, on the other hand, your tendon structure has changed. The tissue becomes disorganized and weak, resembling cooked spaghetti in appearance. Tendinosis typically develops when tendinitis goes untreated or when the tendon is repeatedly overloaded, over the course of months or years.
Now, why does this distinction matter? If you have acute tendinitis, and you treat it with rest, ice and compression, you’ll likely get better. But if you have tendinosis and you try to treat it as if you’re dealing with an acute condition, you’re unlikely to find Achilles tendon pain relief.
Finding the Right Diagnosis
How do you know if you’re dealing with tendinitis or tendinosis? Here, the timeline is often your first clue. If your Achilles tendon pain started within the last few weeks, especially if it followed a specific incident like increasing your running mileage or starting a new sport, it’s probably tendinitis. But if your pain has been going on for years? And if the onset has been gradual, without a specific onset? Or if you’ve tried—and failed—to get relief from multiple treatments? Then it’s probably tendinosis.
Symptoms also differ for each condition.
With tendinitis, you experience:
- Sharp pain
- Visible swelling, or skin that’s warm to the touch surrounding the tendon area
- Pain may improve with rest and worsen with activity
With tendinosis, you may experience
- Dull, aching pain that’s localized around the mid-portion of the Achilles tendon, about two to six centimeters above the spot where it attaches to your heel bone
- Pain that improves with activity and returns later on
- An area of thickening around the tendon
Achilles Tendon Pain Treatment Options
When treating acute tendinitis, we use the traditional approach of Rest, Ice, Compression and Elevation (RICE.) Anti-inflammatory medications might help reduce pain and swelling. Gentle stretching and a gradual return to activity often work well.
Tendinosis requires a completely different approach. Since you’re dealing with degenerative tissue instead of inflammation, treatment must stimulate the tissue so that it can regenerate. This is where eccentric exercises become crucial; they involve lengthening the muscle while it’s contracting. For the Achilles tendon, that will usually involve heel drop exercises. The key with this type of exercise is consistency and progression. You typically start by exercising with both feet at once, then progress to single-leg exercises as you get stronger. The exercises should cause some discomfort—not sharp pain, but a dull ache—as this will stimulate the regenerative process.
Want advanced treatment that dramatically improves outcomes for Achilles tendon pain due to chronic tendinosis? There are two game changing therapies. And they’re both available in our Houston podiatry practice!
Shockwave Therapy for Achilles Tendinosis
Also called EPAT, Shockwave Therapy uses acoustic pressure waves to stimulate healing. When the waves penetrate your tissue, they create controlled micro-trauma that activates your body’s natural healing response. In turn, it increases blood flow to the tendon, bringing nutrients and oxygen that’s essential for healing. It also breaks up calcifications and scar tissue that might be impeding recovery. Most importantly, it triggers the release of your body’s natural healing agents—growth factors and proteins. Treatment is comfortable; you’ll typically need three sessions, spaced by one week, with each visit lasting 10-15 minutes. Many patients notice an improvement in Achilles tendon pain after just one treatment session.
PRP for Chronic Achilles Tendon Pain
Platelet Rich Plasma (PRP) injections use your body’s own healing factors to accelerate recovery. It involves drawing a small amount of your blood, then using specialized equipment to isolate the growth-factor containing platelets. (These are specialized proteins that tell your body to send healing cells to an injured area.) What makes PRP for tendinosis so powerful is that we’re sending a concentrated dose of healing factors directly where they’re needed most. Even more exciting? We can combine PRP and Shockwave Therapy for a powerful combination that creates a healing environment that succeeds where other treatments fail. And the numbers don’t lie—studies reveal that, on its own, Shockwave Therapy has an 82% success rate. When combined with PRP, that number can soar to 95% or higher. Just remember, results won’t be immediate—instead, you’ll start to feel some relief within two to four weeks. However, the full benefit of treatment might not be apparent until three to six months after treatment. Still, unlike quicker fixes, these results will deliver longer-lasting relief for Achilles tendon pain.
Lasting Relief for Achilles Tendon Pain
If you’ve been suffering with tendon pain that won’t go away, it’s time to come in for a visit and figure out what’s going on in your body. Untreated tendinitis can cause tendinosis—tissue degeneration—to develop in your body. And, the longer you wait to seek treatment, the more difficult it may become to stop the degenerative process and stimulate healthy tissue growth.
Remember, healing takes time—it may take as long as six months to experience the full benefits of Achilles tendon pain treatment. However, most patients begin feeling better within weeks of starting treatment. And that means less down time, less discomfort and less of a risk for further tissue degeneration.
Ready to finally put an end to your tendinitis or tendinosis? We’re here to help you find your ideal treatment option—whether that means resting, engaging in specialized exercise programs or taking advantage of the regenerative medicine therapies available in the office. To get started, all you have to do is call the office at 713-785-7881 or follow this link to request your appointment.
