Healing Achilles Tendonosis

[Doclew44]

I am a 75-year-old California psychologist, physically active, and working full-time. I was diagnosed with PMR in January 2018 and have slowly reduced my prednisone dose to 5.5mg., with only one major flare. This forum has been enormously helpful to me In dealing with Prednisone reduction schedules, flares, and rheumatologists.

I have posted about my Achilles tendon pain and swelling on this forum, and learned that it's not an uncommon problem in PMR, Probably due to the effects of steroids. What started as Achilles tendinitis, the acute form of Achilles pain and inflammation, when I injured it doing calisthenics last June, turned into Achilles tendonosis, the chronic form. Although I am an avid hiker and backpacker, I found myself unable to walk more than a few blocks without debilitating pain.

I tried a number of the standard treatments which were not helpful, And then I went to a podiatrist, who recommended shockwave therapy. In the space of five weeks, I have been able to slowly increase my hiking distance to 4 miles of uneven dirt trails. Unfortunately, it was not covered by insurance here, and I had to pay a total of $1000 For five treatments. But it was well worth it to me for relief from this crippling pain. The podiatrist claims it is similarly effective for plantar fasciitis, which can also be caused by steroid medication.

I hope this is helpful for any other members who are suffering from this painful ailment--And who do not get relief from standard treatment protocols.

[Soraya_PMR]

Thanks for sharing.

Wayfair this will interest you!

[SnazzyD]

I’m interested. Though some things say there is not so much evidence for Achilles Tendon, I’m desperate and my home town has lots of sports physios that offer it. Will do some research.

[Doclew44 in reply to SnazzyD]

It has been miraculous for me. The standard treatment is eccentric heel drops but they were too irritating for me. After my second treatment ( out of five), I had no further pain--and was able to begin the heel drops. After nine months of limited ability to walk, it's a wonderful relief. I am planning a five mile hike today.

[rosie2019]

Doing some research on achilles tendonitis as well after months of debilitating issues post prednisone for PMR. Ironically, Rheumotologist seemed unconvinced this was related and has not taken this new issue to heart despite my now inability to walk, particularly in the morning and anytime using stairs. Instead, he pointed me to the neurologist, who thankfully and as expected, found nothing wrong with my muscles or nerves and was adamant that I go back to the Rheumy. When I did, his suggestion was more prednisone which I find ironic as I believe this is a potential cause of my AT. Next step is podiatrist. It amazes me that holistically, there doesn’t seem to be a better understanding of PMR/GCA and related symptoms/side effects from this as well as the drugs we’re put on. Any time something rears its head, I get directed to yet another specialist for X-rays, MRIs, tests, etc. who eventually point me back to the Rheumy indicating my ‘classic’ signs of related issues - shoulder, neck and jaw pain, hip issues, tendonitis, soreness, etc. Is it because there is still so little known about this disease? Although I was a bit of an anomaly being diagnosed in my 40’s, everything I read on this site indicates I’m actually a textbook patient. I’d love to find a doctor who’s read the textbook. Being in DC in the US, I would have thought even my highly recommended and recognised doctor would be a little more up to speed.

[PMRpro Ambassador in reply to rosie2019]

Do you have a history of methyl prednisolone and/or quinolone antibiotics? I did develop AT when put on methyl pred and a quinolone. My husband has no history of steroids but within 48 hours of the quinolone being started he had AT symptoms!

But to be honest, in all the years I have been on the forums and the thousands of patients I have "met" I have only heard of a very small number with AT - maybe 4 or 5 at most.

[rosie2019 in reply to PMRpro]

No history of either. Was feeling fabulous after 2 years into the disease and a very slow taper off pred. Woke up one morning and it literally felt like someone slashed my Achilles during the night about a week or so off my drugs. No previous issues and no other signs of PMR but because it was so sudden and extremely painful, went to doctors to see if it was a related issue.

[PMRpro Ambassador in reply to rosie2019]

That was sudden - you have my sympathy, it is very restricting! The first time I was on crutches for the best part of 9 months. I had a another bit just after new year - appeared after going for a walk a couple of days running after deciding it was time to get a bit fitter! Lockdown seems to have achieved a cure though!!!!

[rosie2019 in reply to PMRpro]

Sorry to hear about your experiences - it is a slow process for healing. Lockdown has been kind to me too - achilles getting some needed rest and plenty of time for stretching and exercise. I do miss running - haven’t been able to start back again after initial symptoms. Looking forward to shaking off some of this extra prednisone baggage! Spring here in Virginia has been amazingly beautiful so plenty of walks!!!