Achilles tendinopathy advice

Elmbow
Elmbow Member Posts: 80
edited 21. Jun 2018, 18:06 in Living with Arthritis archive
Does anyone have any experience of, or advice on, how to deal with Achilles tendinitis? Literally any advice?

Especially anyone with psoriatic arthritis or ankylosing spondylitis (I have one or the other). This has been going on for months and nothing is helping. I am now doing the physio exercises but I think it may even be making it worse.

Comments

  • stickywicket
    stickywicket Member Posts: 27,088
    edited 30. Nov -1, 00:00
    No advice from me except that, if I thought the physio might be detrimental, I'd go back to the physiotherapist to make sure. If there's a long NHS wait I'd go privately. What do your doc and rheumatologist advise?
  • Elmbow
    Elmbow Member Posts: 80
    edited 30. Nov -1, 00:00
    The physio said it could take 6-8 weeks to heal but I'd already had the pain for 3 months. They seemed a bit baffled as most tendinitis is acute and this has clearly gone beyond that. It's obviously related to the spondyloarthropathy, which is why I'm particularly interested to hear from others in the same boat.
    The physio gave me a pass that means I can go back any time in the next 8 weeks if I need to. It's only been a week so too early to say the physio isn't working. At the same time, I don't want to aggravate it. It was improving and now it's getting worse again. It's just frustrating because it's stopping me from doing so much and I don't know if it's ever going to get better until the underlying condition is sorted.
  • Elmbow
    Elmbow Member Posts: 80
    edited 30. Nov -1, 00:00
    Thanks Grace. That is what I suspected. My GP seems to know quite a bit about psoriatic arthritis and tendinitis and the best advice he gave me was to ice it. That is helpful but when I start walking it flares up again. It's just taking soooo long to go away.
  • dreamdaisy
    dreamdaisy Member Posts: 31,520
    edited 30. Nov -1, 00:00
    Hello, I am sorry you are experiencing this bother, it's not pleasant is it? I have PsA, OA and fibro.

    I don't know what your physio has suggested but a suggestion mine came up with to ease the tension in the tendon was to stand a little distance from a wall, my feet facing forwards and at hip's width with my hands in the surrender position at shoulder height: I then lean towards and against the wall, supported by my hands, and I can feel the gentle stretch down the backs of both legs to the ankle. I do this whether it needs doing or not and it, to date, it hasn't returned for over two years. DD
  • TrishaW
    TrishaW Member Posts: 109
    edited 30. Nov -1, 00:00
    Hi there,
    I also get this, though luckily I haven't had it badly for some time now.
    When I first had it my rheumatologist sent me straight to medical supplies for some gel heel inserts, which basically meant I could walk...miraculous.
    I also stretch my achilles daily (eg stand on a stair facing up the stairs with your heel hangong off and push your heel downwards...remember to hold on! You can view exercises on you tube)
    I also use ice and rub voltrol gel (or similar) over the area.
    In terms of shoes, completely flat shoes will flare it up (eg ballet pumps...a no no)...a 1" heel such as on a chunky trainer is best.
    Out of interest, I get achilles tendonitis as a side effect of some antibiotics!
    I hope it eases soon
    Trisha
  • Elmbow
    Elmbow Member Posts: 80
    edited 30. Nov -1, 00:00
    Interesting, thanks. I wasn't give any advice on shoes but I noticed ballet flats definitely make it worse so they're out now.
  • Airwave!
    Airwave! Member Posts: 2,428
    edited 30. Nov -1, 00:00
    Back to basics! Heat will stop the pain, I use my hot wheat bags time and time again, all evening if needed. Cold will stop swelling. Using both will increase circulation and aid healing.

    Hope I'm not teaching you how to suck eggs but people often forget the basics.
  • Elmbow
    Elmbow Member Posts: 80
    edited 30. Nov -1, 00:00
    Thank you, and you are certainly not teaching me to suck eggs - when I said I wanted any advice I meant it - it's been three months now and I'm desperate to get back to my normal activities.

    My excellent GP recommended ice, which I've tried with good results, but not heat. When I saw different people recommending ice or heat I thought, "aaargh, which is it?"; but stupidly I never thought to try BOTH for optimal results!
  • dreamdaisy
    dreamdaisy Member Posts: 31,520
    edited 30. Nov -1, 00:00
    Just to further confuse matters my PsA likes cold and the OA prefers cold. DD
  • Howie
    Howie Member Posts: 3
    edited 31. May 2018, 10:04
    I’ve had Achilles Tendonitis for the past two years, and I know how horrible it is, so I’m really sorry that you’re suffering.

    Over the past two years I’ve seen my GP, a physiotherapist and a consultant orthopaedic surgeon who specialises in the foot. My NHS GP was happy to refer me to the orthopaedic consultant after a couple of months -I’m pretty sure this is NHS normal protocol. I think I waited about six weeks after referral to see him in London. It was diagnosed with ultrasound, and in my case was in both legs though only symptomatic in one. I saw a private physio, just for a couple of sessions, just enough to give me the exercises and to check that I was doing them correctly.

    I guess I’ve learned some things about it on the way.

    The first thing to say is that it isn’t uncommon for the problem to arise without an obvious trauma. No one is sure why.

    And the second thing to say is that it isn’t uncommon for the problem to take a very long time to disappear, years, though everyone assures me that it does normally go away in the end.

    My medics all suggested ice to me, I suppose because it’s so side effect free. I also used anti inflammatoires, including topical ones (creams), and a cream based on chilli peppers called Capsaicin.

    I think physio exercises and massage were helpful, but still they didn’t make the problem disappear. They did at first make it worse, the physiotherapist just said it was because I wasn’t used it, and that I should persist after resting up a bit. I think it’s important to stretch the tendon, and I did persist.

    The surgeon assured me that if the problem didn’t improve there was a “relatively simple operation” to help. Fortunately I’ve not had to go down that route, though I was reassured to know it exists.

    When you sleep, the natural position of your ankle is very bad for your tendon. That’s why it’s often at its worst first thing in the morning apparently. My consultant recommended I buy a splint for this, and wear it in bed, I got one from amazon. I tolerated it well and it had a very noticeable impact on the morning pain.

    The consultant also told me to get some insoles to reduce the impact of walking on my heals. I also googled to find the best trainers for Achilles’ tendonitis, and bought them. These things helped.

    I do a lot of regular low impact exercise and the consultant asked me to reduce this by 10%. Apparently low impact is still impact, which can exacerbate the problem.

    Now, after two years, all pain is gone except in the morning. And the morning pain is much better than it was - I don’t wear the splint or do the physio or take any pain relief any more.

    Best of luck with it, and I hope that there’s light at the end of the tunnel for you.
  • Elmbow
    Elmbow Member Posts: 80
    edited 30. Nov -1, 00:00
    Thanks Howie, that's really helpful. I was considering an overnight splint - the ones I use for my wrists have been quite good.
  • Howie
    Howie Member Posts: 3
    edited 31. May 2018, 13:04
    I forgot to mention something which may in fact be the most important thing.

    All the doctors were really adamant that I should not tolerate the pain if it made me limp. Limping is very bad, they said, because if you limp you tend to try to adjust your gait to reduce the pain, and this means that you end up walking in an unnatural way. The result, they all said, can be pain elsewhere -- knee, ankle or hip. I was told to take anti inflammatories before walking to prevent the pain from causing limping. My GP said she's seen a number of cases where this vicious cycle of pain/adjustment/more pain elsewhere/adjustment . . . was very hard to deal with.

    Oh and a final thing. I was told when I was discharged that some antibiotics -- not all -- can make the problem worse or even recur after a remission. He said that if anyone wanted to prescribe me an antibiotic I should always mention I've had Achilles tendonitis just in case.
  • Elmbow
    Elmbow Member Posts: 80
    edited 30. Nov -1, 00:00
    Same, thanks Howie.
  • TrishaW
    TrishaW Member Posts: 109
    edited 30. Nov -1, 00:00
    Yes take care with antibiotics.....cefixime and drugs in that category causes it in me!
  • TrishaW
    TrishaW Member Posts: 109
    edited 30. Nov -1, 00:00
    Yes take care with antibiotics.....cefixime and drugs in that category causes it in me!

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