Achilles Paratenonitis: Symptoms, Causes, Treatment

What are the symptoms of Achilles paratenonitis?

Achilles paratenonitis, also known as paratendinitis, is a condition that involves inflammation of the paratenon, which is the thin sheath surrounding the Achilles tendon. The symptoms of Achilles paratenonitis can include:

1. Pain and tenderness: The most common symptom is pain along the back of the lower leg, just above the heel. The pain may be worse with activity and improve with rest.
2. Swelling: Swelling around the Achilles tendon and the area just above the heel may occur due to inflammation of the paratenon.
3. Stiffness: You may experience stiffness in the Achilles tendon and calf muscles, especially in the morning or after periods of inactivity.
4. Warmth and redness: The skin over the Achilles tendon may feel warm to the touch and appear red or inflamed.
5. Difficulty walking or running: The pain and stiffness associated with Achilles paratenonitis can make it difficult to walk or run, especially uphill or on uneven surfaces.
6. Creaking sensation: Some people with Achilles paratenonitis may experience a creaking or crackling sensation (crepitus) when moving the ankle.

If you suspect you have Achilles paratenonitis, it’s important to see a healthcare provider for a proper diagnosis and treatment plan. Treatment typically involves rest, ice, elevation, and anti-inflammatory medications, as well as physical therapy exercises to strengthen the Achilles tendon and surrounding muscles. In severe cases, corticosteroid injections or surgery may be necessary.

What are the causes of Achilles paratenonitis?

Achilles paratenonitis is typically caused by overuse or repetitive stress on the Achilles tendon and its surrounding sheath, the paratenon. Some common causes and risk factors include:

1. Overuse: Activities that involve repetitive movements of the foot and ankle, such as running, jumping, or dancing, can strain the Achilles tendon and lead to paratenonitis.
2. Poor footwear: Wearing shoes that do not provide adequate support or cushioning for the foot and ankle can increase the risk of developing Achilles paratenonitis.
3. Sudden increase in activity: A sudden increase in the intensity or duration of physical activity can strain the Achilles tendon and lead to inflammation of the paratenon.
4. Tight calf muscles: Tight calf muscles can put extra stress on the Achilles tendon and increase the risk of developing paratenonitis.
5. Poor biomechanics: Issues with foot alignment or gait abnormalities can increase the risk of developing Achilles paratenonitis.
6. Age: Older adults are more prone to developing Achilles paratenonitis due to the natural weakening of the tendon and surrounding tissues that occurs with age.
7. Previous injury: A history of Achilles tendon injuries or conditions such as Achilles tendonitis can increase the risk of developing paratenonitis.
8. Certain sports: Sports that involve repetitive jumping, running, or sudden changes in direction, such as basketball, soccer, or tennis, can increase the risk of Achilles paratenonitis.

It’s important to address the underlying causes and risk factors to prevent further damage to the Achilles tendon and promote healing. This may involve modifying activities, wearing proper footwear, stretching and strengthening exercises, and, in some cases, physical therapy or other interventions.

What is the treatment for Achilles paratenonitis?

Treatment for Achilles paratenonitis typically involves a combination of rest, ice, compression, and elevation (RICE), along with other conservative measures to reduce pain and inflammation and promote healing. In more severe cases, additional treatments may be necessary. Here are some common treatments for Achilles paratenonitis:

1. Rest: Resting the affected leg and avoiding activities that exacerbate symptoms is important to allow the tendon to heal.
2. Ice: Applying ice packs to the affected area for 15-20 minutes several times a day can help reduce pain and inflammation.
3. Compression: Using a compression bandage or wrap around the lower leg can help reduce swelling and provide support to the tendon.
4. Elevation: Elevating the leg above heart level when lying down can help reduce swelling and improve blood flow to the area.
5. Nonsteroidal anti-inflammatory drugs (NSAIDs): Over-the-counter NSAIDs such as ibuprofen or naproxen can help reduce pain and inflammation.
6. Physical therapy: Stretching and strengthening exercises can help improve flexibility and strength in the calf muscles and Achilles tendon, which can reduce strain on the tendon.
7. Orthotic devices: Using orthotic devices, such as heel lifts or arch supports, can help reduce stress on the Achilles tendon and promote proper alignment of the foot and ankle.
8. Corticosteroid injections: In some cases, corticosteroid injections may be used to reduce pain and inflammation in the tendon.
9. Extracorporeal shockwave therapy (ESWT): ESWT uses shockwaves to stimulate healing in the Achilles tendon and may be used in cases where other treatments have not been effective.
10. Surgery: In severe cases that do not respond to conservative treatments, surgery may be necessary to remove damaged tissue or repair the Achilles tendon.

It’s important to consult with a healthcare provider for an accurate diagnosis and appropriate treatment plan for Achilles paratenonitis. They can help determine the underlying cause of the condition and recommend the most effective treatment options based on your individual needs.