How long do I try non-surgical efforts before Achilles Tendonitis surgery?

by Tracy
(Santa Clara, CA)

I have had severe pain in my right foot for several years.

My regular Dr thought it was plantar fasciitis and gave me treatment options - which worked.

Then I started getting pain in the heel and assumed it was a flare up of PF. Finally went back to doc and he said it's not PF its my Achilles tendon.

Again, used treatment plan but no relief.

Regular Dr sent me to a orthopedic podiatrist because he said the "foot is unique and challenging anatomy and I want you to see someone who really understands what's going on." So off to the podiatrist go I.

Turns out I have a rather large bone spur on the back of both heels - but only symptoms with the right foot. Now I am approximately 5 months into trying non-surgical options. The Podiatrist says, ya we can do surgery but any foot surgery is a hard recovery and let's see what we can do with other options to try to manage / treat the symptoms.

First we go with shoes with a slight lift, get shoe inserts, a toe less sock type thing that has a gel cushion for the heel, a topical pain relief gel and ice. No significant relief from these steps.

Now we are onto extracorporeal shockwave therapy. Has anyone had success with this?

To date, I've gone through 3 treatments. The first one was definitely uncomfortable. The second one, I couldn't make it through because it was too painful. The Doc told that this treatment wouldn't be effective unless he could get the frequency high enough to be therapeutic - which I haven't been tolerating because of the pain.

So, I had well over 8 injections all around the heel to try to numb the area. Didn't get completely numb because I could still feel it.

My possible fourth treatment is next week and I'm a little nervous about it since the shots are painful and then the treatment is uncomfortable. Any experience out there that folks can share with me?

Also, I went back to regular MD for a check up and we talked about any progress on the foot.

He told me to do some research on PRP (Platlet Rich Plasma) therapy. He said it's still somewhat new and experimental and that most insurance companies don't cover it. He had it himself for tennis elbow and said that 2 months after the treatment, he is back to playing tennis.

Has anyone looked into or had PRP for tendonosis / bone spur? Had it done? Have any stores?

Any sharing would be appreciated. thanks.



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Joshua Answers:

Hi Tracy.

1. PRP (Platelest Rich Plasma) therapy can be good. It's an injection of one's own blood plasma to/into areas that don't get a lot of circulation, like tendons.

Thus, it helps actual tendon damage heal faster.

I have no idea why your doctor would recommend it for a bone spur, or for any pain/problem that doesn't include actual tendon damage.

Now, if he was suggesting it for Tendonosis, then that makes more sense.

Tendonosis is essentially tendon degradation due to lack of circulation to a tendon (cells starve and die).

Most everyone has tendonosis to some degree, and of course the worse it is the more problematic it can be.

New blood/nutrition to problem tendonosis areas can help things heal.

But...totally ignores the factors that caused the Tendonosis in the first place.

Essentially, those factors are the Pain Causing Dynamic.


2. Tendonitis is a dynamic. It's made up of multiple factors all working together to cause pain and problem.

Tendonosis is part and parcel of that dynamic, same factors involved.

See: What Is Tendonitis?


3. See: Bone Spur


4. See Related: Achilles Tendonosis Surgery And Bone Spur Debridement Happy And Ready To Do It Again


5. How are things now? Give us an update of what happened since you wrote in.








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Joshua Tucker, B.A., C.M.T.
The Tendonitis Expert
www.TendonitisExpert.com