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Can you tell me more about saline injections for Achilles tendinitis?

Q) I have chronic, painful Achilles tendinitis which is not responding to physiotherapy. I've heard that injections of high volumes of saline can be helpful, and is currently being investigated. Can you tell me more?
Kathleen, York (Autumn 2012)

A) The Achilles can be painful right at the base, where it connects to the heel bone, or further up, about 2–3 inches higher. In the first case, it can often be an early sign of arthritis and further tests may be needed. In the second case, the Achilles is damaged and worn and this may be seen in athletes or people in middle-age. There is some evidence that injecting salt water (saline) can help repair the damage but it is by no means standard practice and it is the latest in line of a number of injection therapies that have been tried in this frustrating condition. I personally favour stretching, and stretching and stretching again – it takes time and effort but works in the end.

This answer was provided by Dr Philip Helliwell for the Autumn 2012 edition of our magazine, Arthritis Today, and was correct at the time of publication.

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