Everyone would like to avoid the intense pain and discomfort of Achilles tendinopathy. That’s because, “The Achilles tendon is one of the most commonly injured tendons that results in significant pain and loss of function. The incidence of Achilles tendinopathy (AT) is 2.35 per 1,000 in the adult population…”[1] Although Achilles tendon injuries are usually associated with athletes, an injury in this area of the foot can happen to anyone. However, “Individuals with diabetes, obesity, dyslipidemia, inflammatory or autoimmune disorders, hypertension, and prior use of oral or injected steroids are at increased risk.”[2]
The Achilles Tendon
The Achilles tendon is both the largest and strongest tendon in the body. This band of fibrous tissue joins the muscles in the calf to the bone of the heel (calcaneus). “The tendon needs to withstand up to eight times body weight in force when undertaking sporting activities, and injuries to the Achilles tendon are common.”[3] Achilles tendon injuries have “…increased in the past 30 years, thought to be due to a combination of an active, aging population and increased participation in sport and exercise programs in general.”[4]
Medical Treatment
“The term ‘Achilles tendinopathy’ encompasses a variety of pathologies characterized by pain and swelling in and around the Achilles tendon.”[5] This results in impaired function. There are many proposed treatments for Achilles tendinopathy. “Tendon loading exercise is the mainstay of initial management, but may be supported by medication, ice, shoe inserts, manual therapy, stretching, taping, or low-level laser.”[6]
To relieve pain and inflammation, oral over-the-counter or prescription pain medications, topical gels, or injected corticosteroids are often prescribed. However, “Corticosteroid injections seem to offer excellent short-term pain relief but lack long term efficacy.”[7] So, rather than chancing the risks associated with taking pain medications long-term or the added pain and ineffectiveness of long-term injections, a much better choice for consistently effective short and long-term pain relief is non-invasive Laser Therapy. Why?
Laser Therapy Promotes Pain Relief
Studies prove that,“In addition to changes in tendon morphology, laser therapy has previously been shown to reduce short- and long-term pain following treatment.”[8] That is because flooding a damaged Achilles tendon with photons of light promotes the increased production of chemicals that reduce pain, such as endorphins and enkephalins. “Fast acting pain relief occurs within minutes of application, which is a result of a neural blockade of the peripheral and sympathetic nerves and the release of neuromuscular contractions leading to a reduction of muscle spasms.”[9]
Laser Therapy Accelerates Healing
Laser Therapy not only relieves Achilles tendon pain quickly, but due to the beneficial chemicals released, Laser Therapy also decreases inflammation and accelerates healing for faster improvement of function. Studies prove that “Radiation of tissue with light causes an increase in mitochondrial products such as ATP, NADH, protein, and RNA…”[10] And its release of nitric oxide (NO) increases circulation, so that blood high in oxygen and nutrients can flow more freely into the Achilles tendon, reducing pain and supporting the body’s natural healing processes. “These low doses of light have demonstrated the ability to heal skin, nerves, tendons, cartilage and bones.”[11] In short, Laser Therapy “… is beneficial for pain relief and can accelerate the body’s ability to heal itself.”[12]
Studies Verify Laser Therapy
Many peer-reviewed scientific studies on http://www.pubmed.gov have found that Laser Therapy can effectively treat Achilles tendinopathy. Here are the results of several studies:
[* Please note that Laser Therapy is also called “low-level laser therapy” or “LLLT.” LLLT is a common acronym used to describe the utilization of lasers for clinical therapy and is not unique to any specific class of laser. Laser Therapy is also commonly referred to as “photobiomodulation” or “PBM.”]
- A 2010 study assessing the clinical effectiveness of low-level laser therapy (LLLT) in the treatment of tendinopathy concluded: “LLLT can potentially be effective in treating tendinopathy when recommended dosages are used. The 12 positive studies provide strong evidence that positive outcomes are associated with the use of current dosage recommendations for the treatment of tendinopathy.”[13]
- A 2013 study evaluating the efficacy of LLLT for sports injuries stated: “In this study, the resulting rate of effectiveness was 65.9% for all sports injuries. However, we have a high rate of effectiveness for Jumper’s knee, tennis elbow and Achilles tendinitis….”[14] In conclusion: “LLLT is an effective treatment for sports injuries, particularly jumper’s knee, tennis elbow and Achilles tendinitis.”[15]
- A 2015 study investigating the effectiveness of eccentric exercises combined with photobiomodulation (PBM) for treating Achilles tendinopathy concluded: “Twice-daily exercise sessions are not necessary as equivalent results can be obtained with two exercise sessions per week. The addition of photobiomodulation as adjunct to exercise can bring added benefit.”[16]
- A 2019 systematic review of 29 clinical studies found that: “In addition, laser-induced photobiomodulation (PBM) was shown to induce changes in membrane permeability, stimulate cytokine reactions, release growth factors, and upregulate ATP, nitric oxide (NO), and oxidation-reduction (REDOX) signaling, and thereby increase metabolism and cell proliferation…this technique showed statistically significant improvements. Moreover, this study suggests that PBM (using the right parameters as an adjunct to minor sessions of eccentric exercise) can provide an added benefit at 12 weeks.”[17]
The Bottom Line – Choose Laser Therapy!
In 2011, a study of participants with Achilles tendon pain found that patients, “…prefer a treatment that costs less, has a greater chance of success, has a shorter duration before being able to exercise free of pain, and has less likelihood of side effects.”[18] Laser Therapy is a treatment option that successfully checks all of these boxes! So if you, a loved one, or your patients are suffering from an Achilles tendon issue, seriously consider using Laser Therapy as a standalone treatment or as an adjunct treatment for better and faster pain relief and quicker restoration of function. Laser Therapy can also be used preventatively to maintain good circulation and help avoid pain and stiffness in not only the Achilles tendon, foot, and ankle, but throughout the entire body!
If you are a chiropractor, medical doctor, physical therapist, acupuncturist, or podiatrist, consider adding Laser Therapy to your treatment menu. The purchase of a laser can make a big difference in your clinic for better patient outcomes, resulting in increased patient satisfaction! For more information on therapeutic lasers, contact Rob Berman at Berman Partners at 860-707-4220, or complete the contact us page.
[1] McClinton S, Luedke L, Clewley D. Nonsurgical Management of Midsubstance Achilles Tendinopathy. Clin Podiatr Med Surg. 2017 Apr;34(2):137-160. doi: 10.1016/j.cpm.2016.10.004. Epub 2016 Dec 1. PMID: 28257671, p. 1.
[2] Ibid., p. 2.
[3] Touzell A. The Achilles tendon: Management of acute and chronic conditions. Aust J Gen Pract. 2020 Nov;49(11):715-719. doi: 10.31128/AJGP-07-20-5506. PMID: 33123713, p. 2.
[4]Ibid.
[5] Ibid., p. 6.
[6] McClinton S, Luedke L, Clewley D. Nonsurgical Management of Midsubstance Achilles Tendinopathy. Clin Podiatr Med Surg. 2017 Apr;34(2):137-160. doi: 10.1016/j.cpm.2016.10.004. Epub 2016 Dec 1. PMID: 28257671, p. 1.
[7] Skjong CC, Meininger AK, Ho SS. Tendinopathy treatment: where is the evidence? Clin Sports Med. 2012 Apr;31(2):329-50. doi: 10.1016/j.csm.2011.11.003. PMID: 22341021, Abstract.
[8] Corrigan P, Cortes DH, Silbernagel KG. Immediate effect of photobiomodulation therapy on Achilles tendon morphology and mechanical properties: an exploratory study. Transl Sports Med. 2019 Jul;2(4):164-172. doi: 10.1002/tsm2.78. Epub 2019 Mar 1. PMID: 31742249; PMCID: PMC6860369,p. 7.
[9] Cotler, Howard B. et al. The Use of Low Level Laser Therapy (LLLT) For Musculoskeletal Pain. MOJ Orthop Rheumatol. 2015 ; 2(5): . doi:10.15406/mojor.2015.02.00068, p. 5.
[10] Chung, Hoon, et al. The Nuts and Bolts of Low-level Laser (Light) Therapy. Ann Biomed Eng. 2012 February; 40(2): 516–533. doi:10.1007/s10439-011-0454-7, p. 5 of NIH Public Access version.
[11] Cotler, Howard B. et al. The Use of Low Level Laser Therapy (LLLT) For Musculoskeletal Pain. MOJ Orthop Rheumatol. 2015 ; 2(5): . doi:10.15406/mojor.2015.02.00068, p. 4.
[12] Ibid., p. 7.
[13] Tumilty S, Munn J, McDonough S, Hurley DA, Basford JR, Baxter GD. Low level laser treatment of tendinopathy: a systematic review with meta-analysis. Photomed Laser Surg. 2010 Feb;28(1):3-16. doi: 10.1089/pho.2008.2470. PMID: 19708800, Abstract.
[14] Morimoto Y, Saito A, Tokuhashi Y. Low level laser therapy for sports injuries. Laser Ther. 2013;22(1):17-20. doi: 10.5978/islsm.13-or-01. PMID: 24155545; PMCID: PMC3799051, Abstract.
[15] Ibid.
[16] Tumilty S, Mani R, Baxter GD. Photobiomodulation and eccentric exercise for Achilles tendinopathy: a randomized controlled trial. Lasers Med Sci. 2016 Jan;31(1):127-35. doi: 10.1007/s10103-015-1840-4. Epub 2015 Nov 26. PMID: 26610637, Abstract.
[17] Pavone V, Vescio A, Mobilia G, Dimartino S, Di Stefano G, Culmone A, Testa G. Conservative Treatment of Chronic Achilles Tendinopathy: A Systematic Review. J Funct Morphol Kinesiol. 2019 Jul 22;4(3):46. doi: 10.3390/jfmk4030046. PMID: 33467361; PMCID: PMC7739415, pps. 7-8.
[18] Sweeting KR, Whitty JA, Scuffham PA, Yelland MJ. Patient preferences for treatment of achilles tendon pain: results from a discrete-choice experiment. Patient. 2011;4(1):45-54. doi: 10.2165/11532830-000000000-00000. PMID: 21766893, Abstract.
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