Achilles tendinopathy - What works best?

Achilles tendinopathy is an overload injury that can affect the distal insertion or the midportion of the tendon. Patients can expect their symptoms to improve between 3-12 months, however, around 1 in 4 patients will experience pain 10 years after treatment.

The main treatment options include:-

# Wait-and-see

# Exercise therapy

# Injections

# Shockwave therapy

# Orthosis

# Medication

# Surgery

Many patients will receive multiple treatments, so the comparative effectiveness of treatments is difficult. However, what has been apparent is that wait-and-see approaches are not advised due to lack of progress. Calf muscle exercise therapy is easy to prescribe in practice, is widely available, and is regarded as safe and cheap. Exercise therapy should be considered as a starting approach to treatment. If exercise therapy is to fail, then alternative approaches should be considered.