Sharp Pain in the Achilles Tendon

Sharp Pain in the Achilles Tendon

If your Achilles tendon pain is sharp and it is not getting better after approximately 1-3 months of conservative therapy:

Conservative Home Treatment Guide

Then it is likely that you may have had some nervous tissue impingement or scarring develop. The odds are greatly on your side that this is just a condition termed neuropraxia- which is just irritation of the nerve that lasts for a couple weeks before calming down, even if the inflammation in your Achilles tendon has already decreased. You should continue conservative therapy for another 3 months and wait for the neuropraxia to decrease. There are more aggressive anti-inflammation treatment options such as wearing a CAM walker, iontophoresis and injections.


The sharp pain explained

This means that you may have nerve irritation from the inflammation that occurred around your Achilles tendon, this will take approximately 2-3 weeks or more to calm down after the inflammation has been removed.


Extensive Home Treatment

Before considering surgery- you should do your best to offload and reduce tension. Casting and CAM walker boots are the ultimate offloading method before surgery is to be considered.
It is a good idea to continue reducing pressure onto the area by finding anyway to prevent rubbing against the back of the foot, lifting the heel to remove tension onto the heel. It is also preferable to also continue reducing inflammation by continuing to take anti-inflammatories and Icing the region.
Corticosteroids should not be advocated as injections around the Achilles tendon have been shown to increase the risk of rupture.

Immobilize the foot with:

  • Continue initial treatments – Conservative Home Treatment Guide
  • Avoid corticosteroid injections into the Achilles tendon– studies have shown that corticosteroids can weaken the tendon if they are directly injected into the tendon, but if bursitis is present than it may be beneficial to decrease inflammation around the Achilles tendon and decrease nerve irritation.
  • Iontophoresis – Two pads with an electrical charge combine to transport chemicals through the skin
  • Inject the Bursa- If bursitis is present, injection into the bursa can be attempted, but avoid the achilles tendon
  • CAM Walker -Immobilization is the final step to preventing surgery, it is usually done for approximately 2 weeks
  • Cast -Immobilization is the final step to preventing surgery, it is usually done for approximately 2 weeks