Achilles tendon pain

Who it may help

TAME may suit you if:

• you have had Achilles tendon pain for more than 3 months
• you have tried physiotherapy, medication, shockwave therapy or injections without lasting relief
• you want to avoid or delay surgery
• imaging shows abnormal blood flow or inflammation near the tendon

Understanding Achilles tendinopathy

Pain at the back of your heel can make walking or even standing difficult. Achilles tendinopathy (often called Achilles tendonitis) is a common cause, especially in people who are active or on their feet for long hours.

The Achilles tendon is the strongest tendon in the body. It connects the calf muscles to the heel bone and is used in walking, running, climbing stairs and standing on your toes.

What happens in Achilles tendinopathy

In chronic Achilles tendinopathy, the tendon becomes painful and thickened, and is damaged over time. This usually develops because of:

• repetitive strain or overuse, which is common in sport or active work
• the way your feet and legs move (biomechanics)
• age-related wear and tear

Unlike a sudden injury, this is a degenerative condition, not just simple inflammation.

Common symptoms

• A dull ache or stiffness behind the heel
• Pain that worsens with walking, running or climbing stairs
• Swelling or tenderness around the tendon

Usual treatments

Treatment usually starts with:

• rest and changes to activity
• heel lifts or braces
• physiotherapy
• anti-inflammatory medication

If pain continues beyond 3–6 months, these treatments may no longer give enough relief.

A newer option: TAME

For people with ongoing pain, a newer minimally invasive procedure called transarterial microembolisation (TAME) may help.

It targets abnormal tiny blood vessels that form around the damaged tendon and add to ongoing inflammation and pain. Blocking these vessels aims to reduce pain and allow the tendon to heal.

How the procedure is performed

1. The procedure is performed by an interventional radiologist.
2. It is done under local anaesthetic with mild sedation.
3. A tiny catheter (tube) is inserted into an artery, usually in the groin.
4. Using live X-ray guidance, the catheter is passed to the arteries supplying the Achilles tendon.
5. Tiny particles are injected to block the abnormal vessels while keeping normal circulation.
6. The procedure usually takes about an hour, and you go home the same day.

Benefits

• No surgical incision
• Local anaesthetic rather than a general anaesthetic
• Most people return to normal activity within days
• Pain often improves within weeks
• May improve mobility and reduce reliance on medication
• May delay or avoid surgery

After the procedure

• Most people go home the same day.
• Light activities can usually resume within a few days.
• Pain usually improves gradually over several weeks to months.
• Some studies have reported pain relief and better function lasting up to two years.
• Physiotherapy is recommended to help restore strength and flexibility.