Achillodynia
| Classification according to ICD-10 | |
|---|---|
| M76.6 | Achilles tendonitis |
| ICD-10 online (WHO version 2019) | |
The Achilles tendon is a pain syndrome of the Achilles tendon , the attachment of the calf muscles on the heel bone . Together with the golf elbow and the tennis elbow, it belongs to the group of insertion tendinopathies. It is an inflammatory reaction to mechanical damage to tendon tissue caused by microtraumas and is therefore a rather common disease. The changes in the tissue usually occur about 2–6 cm above the attachment point on the calcaneus.
causes
A local, mostly chronic overuse of the Achilles tendon is seen as the cause of achillodynia, with constant, uniform loads ( long-distance running ) as well as unfamiliar, short activities (starting a new sport). In many cases the cause cannot be identified. In addition, achillodynia also occur as a result of other diseases such as osteoarthritis of the ankle or foot deformation.
Symptoms
The main symptom of achillodynia is the intensity of the pain in the course of the Achilles tendon, which is usually associated with swelling.
Diagnosis
A clinical examination and sonography are usually sufficient to confirm the diagnosis. Occasionally, an X-ray examination to rule out a posterior heel spur is useful.
therapy
- Regular stretching of the calf muscles - but not by stretching the leg of the calf to be stretched backwards, as known from ski gymnastics (this stretch is too weak and inefficient). Rather, a block of wood, wedge or similar should be used when standing upright (!) placed under the forefoot.
- Cooling, e.g. B. by ice treatments.
- Load reduction.
- Relief - the tendon can be relieved of its basic tension by increasing the heel (only for a short time, otherwise it will shorten).
- Ointment rubbings, e.g. B. with diclofenac .
- Special bandages.
- Massages are controversial among doctors.
- Physiotherapy, etc. a. with eccentric muscle training below the pain threshold
- Injections with cortisone are controversial among doctors because, in addition to being effective, they increase the risk of tendon tears (this is already increased by the disease itself).
- The shock wave therapy is a relatively new treatment option. It is not taken over by the federal German statutory health insurance because of its controversial effectiveness.
- Sensorimotor insoles
- Radiation therapy can be helpful after weighing the risk of radiation.
- Simultaneous procedure with ultrasound .
- In the case of long-standing complaints that cannot be managed conservatively, splitting the tendon longitudinally and peeling off the dead area is helpful
forecast
If the course goes well, the achillodynia subsides again under the therapy mentioned. Chronic courses are not uncommon. One complication is the rupture of the tendon.
