What treatment is available for a swollen and paining Achilles tendon?

Hi,

Welcome to icliniq.com.

Firstly, there is no attachment and hence I could not see the clinical picture. You have mentioned about the pain at the back of your ankle along with swelling over the affected region. The injury as described by you could be Achilles Tendinitis or a partial tear in the tendon especially if there was any injury which you can recollect immediately preceding the onset of your symptoms. Your symptoms right now do not appear to be related to your lower back region as it would not cause any associated swelling, although the variable presentation of pain can be there as a nerve may be getting impinged in your back region as a result of herniated L5/S1 disc. It is actually difficult to tell you any treatment without arriving at a diagnosis, but I can guide you as to what is needed. Ice compression may help you to get relief from swelling and pain. The elevation of your limb, especially at night may also help in reducing the associated swelling around the back of your ankle. You can take a gentle anti-inflammatory medication like Ibuprofen or Diclofenac or Paracetamol along with medications to reduce swelling. You will need to do certain tests like complete blood count, erythrocyte sedimentation rate, C-reactive proteins, and serum uric acid levels. To rule out an Achilles tendon tear, you need to undergo an MRI of the affected region and not an ultrasound. MRI is also indicated if you have an associated weakness of your ankle plantar flexion but that can be assessed only by a trained orthopedic surgeon as it will require a clinical examination. On the contrary, if these symptoms are due to the spine, it will not cause any swelling. In that case, activity modification, anti-inflammatory medications and medications to reduce neuropathic symptoms like Pregabalin or Gabapentin may be initiated for relief. If you can send me the clinical picture, I can assess it and let you know my opinion. Also, please send the ultrasound report and if possible MRI of your ankle with emphasis on tendon Achilles integrity. Do get the blood investigations done to rule out any infection or any other inflammatory cause for pain and swelling.

Thank you.

Hi,

Welcome back to icliniq.com.

Thanks for sending me your images (attachment removed to protect the patient's identity) and sorry that you had trouble uploading your initial images. It appears that there is not only swelling but also an erythematous patch all along the tendon. So I would like to see the MRI for this, and then a decision can be taken whether this needs to be managed conservatively or through any procedure. You can actually feel the tendon all along your leg, which becomes better, especially if you stretch your foot upwards. If you feel any depression or any sort of discontinuity in the tendon, please get an MRI done because tendon Achilles injuries cannot be neglected. The healing by itself in the case of a complete rupture is very poor. Meanwhile, you can apply a brace till you can get your tests done.

Thank you.