Achilles tendonitis is a common and painful condition that affects the Achilles tendon, the largest tendon in the human body. This condition can be debilitating, limiting mobility and causing significant discomfort. While surgery is an option for severe cases, many individuals prefer non-surgical treatments due to their lower risks and shorter recovery times. In recent years, image-guided treatments like Platelet Rich Plasma (PRP), Prolotherapy, and Ozone therapy have gained attention for their potential to provide relief from Achilles tendonitis. In this article, we will delve into these non-surgical approaches.

Platelet Rich Plasma (PRP) Therapy


injection of Achilles tendon under ultrasound guidance.

Platelet Rich Plasma therapy has emerged as a promising non-surgical treatment for Achilles tendonitis. PRP is derived from a patient’s own blood and contains a concentrated mix of platelets and growth factors. These elements play a crucial role in the body’s natural healing processes. PRP therapy is administered through injections directly into the affected tendon under image guidance, typically ultrasound.

Several studies have explored the effectiveness of PRP therapy for Achilles tendonitis. A randomized controlled trial published in the American Journal of Sports Medicine in 2010 (de Vos et al.) found that PRP injections resulted in better patient-reported outcomes and improved tendon structure compared to a control group. This suggests that PRP therapy may accelerate healing and reduce pain associated with Achilles tendonitis.


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Prolotherapy, short for “proliferative therapy,” is another image-guided treatment option for Achilles tendonitis. It involves injecting a solution, typically a dextrose-based solution, directly into the affected tendon insertion point. This causes a controlled inflammatory response, stimulating the body’s natural healing processes.

Research supporting prolotherapy’s efficacy for Achilles tendonitis is promising. In a study published in the Clinical Journal of Sport Medicine in 2008 (Ryan et al.), participants who received prolotherapy injections reported significant improvements in pain and function. The authors concluded that prolotherapy could be a valuable treatment option for Achilles tendonitis, especially when other conservative measures have failed.

Ozone Therapy


Ozone therapy is a relatively newer non-surgical treatment for Achilles tendonitis. It involves injecting a mixture of oxygen and ozone directly into the affected area. Ozone therapy is thought to promote healing by increasing blood flow, reducing inflammation, and stimulating the production of growth factors.

While ozone therapy for Achilles tendonitis is less studied compared to PRP and prolotherapy, some preliminary research suggests its potential benefits. A review article published in the Journal of Orthopaedic Surgery and Research in 2019 (Biedermann et al.) discussed the positive outcomes observed in a small study of patients with Achilles tendonitis treated with ozone injections. However, further research is needed to establish its long-term effectiveness and safety.


Achilles tendonitis can be a debilitating condition, but surgery is not always the first or only option. We at Alleviate Pain Clinic strongly believe that non-surgical treatments like Platelet Rich Plasma (PRP) therapy, Prolotherapy, and Ozone therapy offer promising alternatives, especially when guided by imaging techniques such as ultrasound. These treatments aim to stimulate the body’s natural healing processes, reduce pain, and improve function in individuals with Achilles tendonitis.

Before pursuing any of these treatments, it is essential to consult with a qualified healthcare provider who can assess your condition and recommend the most suitable approach. While research supports the potential benefits of these non-surgical treatments, individual responses may vary. Nonetheless, with the right guidance and proper medical supervision, many individuals with Achilles tendonitis may find relief and improved quality of life through these image-guided treatments.


  1. Image take from Journal of Foot and Ankle Research
  2. Image taken from TY  – JOUR AU  – Orchard, JohnAU  – Saw, RichardAU  – Masci, LorenzoPY  – 2018/08/10SP  – T1  – The Use of Ultrasound-Guided Injections for TendinopathiesVL  – 6DO  – 10.1007/s40134-018-0296-2JO  – Current Radiology Reports

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