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"Is Achilles surgery imminent?"


I apparently have a small tear in my Achilles. I have a bone spur that broke off and is lodged in the tendon. We tried several weeks of PT to help with the pain and when that did not work, did the MRI to discover the tear. My doctor then booted my foot for 3 weeks. The pain is much better but I am out of the boot and I can already feel the lingering uncomfortable sensation. My doctor said the boot wasn't to heal the tear, only to calm down the inflammation so the pain would be lessened. He says I could still need surgery if the pain gets to be too much again. So I'm wondering if I have any hope of this being ok or if I'm doomed to surgery if I ultimately want a pain free foot that I can exercise on? Is there anything else non surgical I could be doing?


Thanks for your question, and I recommend that you discuss it with your doctor. At this point, it sounds like your doctor has been moving through the various options in a well thought out manner. The first thing with most orthopedic injuries is to try and manage them conservatively (in most cases, although there are obvious exceptions to this, such as many types of fractures, etc).

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With physical therapy and time, many problems will be able to resolve in a manner that allows for relatively pain free return to normal function without significant impairment of quality of life. In the unfortunate situations in which that doesn't work, there are a number of other methods that can be employed, each of which falls within the realm of physical therapy in most instances. In other words, there are various techniques that can be employed by physical therapists that can vary in style and substance. At the end of the day, the outcomes are not vastly different in most instances. Once time has been allowed to pass and there is a demonstrated failure to return to pre-injury function, the discussion of surgery comes up again. It is important to know that even surgery does not guarantee complete return to your pre-injury state. Please speak with your doctor about this question.

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