Over the counter anti-inflammatory pain relievers offer only short-term relief. Getting well and staying well requires more than simple pain relief. It’s actually a good idea to avoid over-the-counter pain relievers in the NSAID class. NSAIDs such as Advil and Tylenol, as well as the herb white willow bark, can actually contribute to the degradation of cartilage, slow down healing, and lead you to injure your heel all over again.
There are several natural interventions that can make a noticeable difference in how quickly you recover from Achilles tendonitis:
- Ice packs are universally recommended in treating injury and swelling. The problem is that not everyone feels better after applying a cold pack (such as ColdCure) to the skin over the Achilles tendon. Use other methods if applying ice increases rather than decreases pain. Usually ice is needed most in the first two weeks following an injury.
- Magnet therapy is clinically demonstrated to offer relief for Achilles tendon pain, but there's a catch. Magnetic field needs to be pulsating, not static. Simply taping a magnet on your heel or calf muscle is not likely to offer much relief. Pulsating magnetic field is thought to work by altering the production of inflammatory bradykinins in the heel itself.
- Extracorporeal shockwave therapy (ESWT) from therapeutic ultrasound has a good track record in accelerating recovery from tissue injury. There are hand-held therapeutic ultrasound units for home use available from many online vendors.
- Transcutaneous electroneural stimulation (TENS) is another self-directed therapy that can relieve both swelling and pain in Achilles tendon injury. TENS units are also available from many online vendors.
- Many different herbs relieve pain, but relatively few relieve both pain and inflammation. For pain caused by inflammation, the German combination remedy Phytodolor, a blend of ash, poplar, and goldenrod extracts, is backed up with the best scientific evidence. No fewer than ten scientific studies confirm its usefulness in controlling muscle and bone pain with a virtual absence of side effects. This remedy may be particularly appropriate for Achilles tendon pain because it normalizes red blood cells in contact with the affected tissues. This product is sold in the UK, Ireland, and continental Europe under the trade name Phytodolor; in the United States and Canada you can ask an herbalist about a near equivalent.
- Another “herbal” remedy is capsaicin. It's the active ingredient in products like Icy Hot and Tiger Balm (which combines capsaicin and menthol). Capsaicin is the chemical that gives hot peppers their heat. As anyone who has cooked with chilis knows, capsaicin can cause burning, redness, and inflammation, especially to the eyes and mouth. The first time it is applied in a cream to the skin over a painful injury, capsaicin causes these symptoms, but the nerve fibers serving the back of the leg become insensitive to it—and to pain. Capsaicin works best when there is good circulation to the skin to which it is applied. Do not apply capsaicin to your legs if you have diabetes and never apply capsaicin to ulcerated skin. Keep capsaicin out of your nose and eyes. Allergic reactions to capsaicin are rare but are not unknown, and there have been cases of hypothermia in people who used capsaicin in an especially cold room. It is theoretically possible that capsaicin absorbed into the bloodstream could reduce the bioavailability of aspirin; if you use capsaicin, use pain relievers other than aspirin.
- Glucosamine and chondroitin may be helpful in recovery from tendon injuries, but the glucosamine contributes more to healing than the chondroitin. You can increase the effectiveness of glucosamine and chondroitin by drinking green tea once or twice a day. The bright green, strong matcha teas made with powder in boiling water, not with tea bags, will provide the most noticeable effect.
- Cherry juice is reliable natural remedy for soft tissue injuries of all kinds, especially in soft tissues that receive relatively little blood circulation. Dr. Russell Reiter of the University of Texas Health Science Center in San Antonio has confirmed that cherries, especially Montmorency cherries, relieve tissue injury by providing antioxidants that regulate inflammatory processes. Either 2 cups (500 ml) of unsweetened cherry juice or ½ pound (250 grams) pitted cherries daily is an optimal dose.
- What about surgery? Surgery for Achilles tendonitis is about 95 per cent effective when the condition is caused by an identifiable injury, but much less likely to produce good results when the immune system is involved (Achilles tendonosus). Recovery from surgery can take as long as six months.