Tendonitis is a common painful condition that can affect tendons around a joint. In most cases, tendonitis is a self-limiting condition and will improve after a period of activity limitation. Tendonitis was previously believed to be a condition of inflammation within a tendon. However, it is now understood that tendonitis does not involve inflammation and instead represents multiple micro-tears accumulating and the tendon generating a healing response. Most cases of tendonitis are caused by a sudden change or increase in your activity levels.
One of the common tendinopathies is Achilles tendinopathy. It is a self-limiting condition for most people and will improve after a period of activity limitation. Only a small proportion of people with Achilles tendinopathy require any formal treatment from a doctor or physiotherapist if the pain does not settle. However, tendons are slow to heal and it may take several weeks or months for complete improvement. Activities that cause your heel pain should be avoided where possible. This may require altering your exercise or recreational activities and a discussion with your employers if you require amended duties. High-impact activities such as running should be limited and a slow, graded return to these activities is vital when your symptoms start to improve. It is also important to ensure that you are wearing footwear with appropriate cushioning.
Simple measures to help improve your symptoms include applying a cold compress or ice pack to the affected area during painful episodes. Simple painkiller medications can also provide some relief, with anti-inflammatory gels/creams applied to the skin most effective. The best way of permanently resolving your Achilles tendinopathy is the use of specialised stretching and strengthening exercises (eccentric), though this can take several months for significant improvement to occur.
For most people, Achilles tendinopathy can be self-managed. Most important is a period of rest and avoidance of activities that cause pain, this may require alteration to your normal exercise routine. Where your symptoms are causing significant limitations or have failed to improve after self-treatment measures, you should make an appointment with your doctor. Your doctor may advise you on further options for pain killers, exercises or they may refer you to a physiotherapist.
Very occasionally if your symptoms are severe or very longstanding your doctor may refer you to a specialist where further treatment options can be considered including shockwave therapy or, as a last resort, surgery.