Woman pulling an arrow out of her Achilles tendon

Psoriatic Arthritis Tendon Pain: Improve Your Achilles Tendonitis

If you’ve been diagnosed with Achilles tendonitis, you know how frustrating it is to hobble around in the morning because your ankles won’t bend. Or the pain of it “catching” as you walk downstairs or as you lift up on your tippy-toes.

In approximately 50% of people with psoriatic arthritis, tendon pain continues to be a problem.

What is Achilles tendonitis?

Your Achilles tendon is what connects the calf muscle to the heel bone. Like plantar fasciitis the problem is inflammation, but Achilles pain is at the back of the heel rather than under it.

Poor foot mechanics, overuse, weight gain, or even just increasing the amount of walking/exercise you do can all cause a flare. Your rheumatologist, physiotherapist, general Practitioner, and the podiatrist may all be involved in addressing this problem.

Here are a few techniques for pain relief and improved symptoms.

Stretching and massage

If you’re lucky like me, you have both plantar fasciitis and Achilles tendonitis. Silver lining: the stretching exercises for both are similar. Gentle toe stretches using your hands or a towel and calf stretches are great – just remember not to stretch to the point of pain.

You can also use massage to loosen up tight muscles. If you can’t afford professional treatments, there are lots of great foam rollers on the market that you can use at home.

Strengthening and Taping

Again, like plantar fasciitis, strengthening exercises are recommended. Toe raises are great for this. Start on the floor, and once you build up strength and flexibility you can move to the stairs (just be very careful and don’t overdo it).

Google “toe raise + Achilles tendonitis” for lots of great variations. If you’re working with a physiotherapist or personal trainer, they may recommend taping or light brace options during exercise sessions. Don’t attempt to tape yourself unless you have been shown how by a professional.

Address foot mechanics

While overuse may exacerbate Achilles tendonitis, it is often underpinned by poor foot mechanics. Maybe you have flat feet like me, or maybe you wear restrictive shoes that throw your natural foot mechanics out of whack.

Whichever it is, a chiropractor or podiatrist may be able to help with structured shoes and special inserts. Heel cups and cushions are good places to start your search.

Relieving pain from Achilles tendonitis

If pain from Achilles tendonitis is severe, you may be prescribed NSAIDs or other pain relievers. The benefit of NSAIDs over something like Tylenol is that they help reduce inflammation as well as relieve pain (just watch that they don’t irritate your stomach).

You may also be offered corticosteroid injections, but note that like NSAIDs the relief is only temporary, and there are case reports of Achilles rupture after such procedures. Lastly, good old rest, elevation, and ice can help in a pinch. Try out some compression socks and see if those help too.

Prolotherapy and shockwave treatments

Prolotherapy involves localized injections of dextrose solution to stimulate repair. Shockwave treatments are not invasive but follow the same principle, encouraging damaged/scarred tissues to repair themselves. Talk with your doctor and other specialists to discuss these treatment options, and make sure they are administered by reputable professionals.

Surgical options

In severe cases, doctors may recommend surgery as a last resort. Most resources describe the process for relieving tendinopathy/tendinosis rather than tendonitis, but the principles are the same – remove diseased tissue or any deposits that are causing problems. Discuss all options with your doctor.

If you’re suffering from any of the symptoms of Achilles tendonitis, have a chat with your specialists, and let us know what helps you in the comments!

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