Achilles Tendinopathy (Tendonitis) – Best treatment options

The best treatment approach for chronic Achilles tendinopathy remains load modification and exercise rehabilitation. But it can be a difficult condition to settle and can cause significant pain and disability for sufferers. So if basic conservative management has failed or is taking longer than anticipated, what are the possible treatment options and is shockwave therapy one of them?

Chronic Achilles tendinopathy treatment options?

Beyond the normal fundamental but essential conservative treatment options such as load modification, exercise rehabilitation etc, what other treatments are available:

Non-invasive Treatment options for Achilles pain?

• Shockwave therapy – effective pain reduction in the short but more importantly long term. It promotes a natural healing and longer term results show it works over many months. There is no rest period required and you can return to modified loading and your rehabilitation almost immediately.

Outcome studies have shown significant improvements in pain and function with the combination of exercise rehabilitation and shockwave therapy in Achilles tendinopathy. We would always advise this non-invasive treatment as a preferred option before considering an invasive one.

Shockwave therapy benefits

• Non invasive
• Fast and effective pain relief
• No complications
• No period of rest or recovery from procedure

Are all shockwaves equal?

• Quality shockwave therapy equipment is crucial for great results. Some cheaper machines fail to provide the same levels of energy as higher quality machines. At Physis we use Storz Medical equipment due to its high quality and crucially the most clinical evidence to support its effectiveness.
• Experienced shockwave therapists are also crucial for good results. Not only should they be well trained and experienced but they will also understand that although shockwave therapy works well, a combined approach with the correct load management plan and exercise rehabilitation is far more beneficial for patients. So our team will provide both for you.
• There are two types of shockwave machine, radial and focused. There are some crucial differences generally but in terms of achilles tendinopathy, they are:

1. Radial usually takes slightly more sessions to get maximum effect (average 4-6 sessions) compared to the focused device where often 3 sessions are all that is required.
2. Focused can provide greater energy levels with less discomfort which can be very important for chronic recalcitrant plantar heel pain (over 6-9 months).
3. Insertional problems closer to the bony insertion are often better treated with focused shockwave.

Our shockwave therapists are specialist sports physiotherapists and are always available to discuss all the pros and cons to allow you to choose the best option so feel free to give us a call on 0131 478 4646. and arrange to speak to one of them.

Is shockwave treatment covered by medical insurance?

It is covered by most medical insurance companies or available for self funding patients.

To book a course of treatment at our South Edinburg Physiotherapy Clinic or to arrange to speak to one of our team, contact us.

Invasive Treatment Options

• Steroid injection – a guided steroid injection can help reduce pain in the short term but does have some associated risk factors including rupture. But a reduction in pain can allow exercise therapy to progress in those patients where the pain has limited conservative management. After injection there must be an initial period of rest before activity can restart.
• Surgery – as usual a last resort which carries low risk of complications and a long period of rehabilitation before a return to activity/sport.

We now provide an even wider range of shockwave services:

For urological conditions such as Erectile Dysfunction (ED), Peyronies Disease and Prostatitis follow the link to our specialist shockwave service – Edinburgh Shockwave.