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PRP for Achilles Tendonitis

Achilles tendonitis is a common condition that occurs when the Achilles tendon, which connects the calf muscles to the heel bone, becomes inflamed. This can cause pain, stiffness, and swelling in the back of the ankle, making it difficult to walk or engage in physical activity. While traditional treatments such as rest, ice, and physical therapy can be effective, some patients may require more advanced treatments, such as platelet-rich plasma (PRP) therapy to completely eradicate a patients pain.

PRP therapy is a form of regenerative medicine that uses a patient's own blood to promote healing. The process involves drawing a small amount of blood from the patient, which is then processed to concentrate the platelets and growth factors. The concentrated PRP is then injected into the affected area, such as the Achilles tendon, to stimulate healing.

In the case of Achilles tendonitis, PRP injections can help promote healing and reduce inflammation. The growth factors in the PRP stimulate the regeneration of damaged tissue and can also help to increase blood flow to the area, which can aid in the healing process.

PRP therapy for Achilles tendonitis is typically performed on an outpatient basis, using ultrasound guidance to ensure precise placement of the injections. The procedure itself is relatively simple and takes only a few minutes to complete. Patients may experience some mild discomfort at the injection site, but this typically subsides within a few days.

Following the injection, patients may be advised to limit physical activity for a short period to allow the healing process to take place. Full recovery may take several weeks to months, depending on the severity of the injury and the individual's healing response. In some cases, multiple injections may be necessary to achieve optimal results.

PRP therapy is considered a safe and effective treatment option for Achilles tendonitis, with minimal risk of adverse effects or complications. Patients should discuss the potential risks and benefits of PRP therapy with their healthcare provider before undergoing treatment. You may wonder why not get a cortisone injection for this pain, which is a treatment covered by insurance.


Corticosteroid injections are a commonly used treatment for foot and ankle conditions, such as plantar fasciitis, Achilles tendonitis, and ankle sprains. These injections work by reducing inflammation and pain in the affected area. While corticosteroid injections can be an effective treatment option, there are potential downsides to consider.

One of the main downsides of corticosteroid injections is the risk of side effects. Corticosteroids are powerful drugs that can affect multiple systems in the body, including the immune system, metabolism, and bone health. Some of the common side effects of corticosteroid injections include:

  • Pain and swelling at the injection site

  • Temporary increase in blood sugar levels

  • Mood changes, such as irritability or anxiety

  • Insomnia or difficulty sleeping

  • Increased risk of infection

  • Weakening of the tendons and ligaments in the injected area

  • Osteoporosis or bone thinning with long-term use

Another potential downside of corticosteroid injections is that they may not address the underlying cause of the condition. While corticosteroids can provide temporary relief of symptoms, they do not promote healing or address the root cause of the problem (unlike PRP). This means that the symptoms may return once the effects of the injection wear off, and the underlying condition may continue to worsen over time.

Additionally, repeated use of corticosteroid injections can lead to diminished effectiveness and may increase the risk of side effects. This is because the body can become desensitized to the effects of the corticosteroids over time, requiring higher doses or more frequent injections to achieve the same level of pain relief.


In conclusion, while corticosteroid injections can be a useful treatment option for foot and ankle conditions, there are potential downsides to consider. Patients should discuss the risks and benefits of corticosteroid injections with their healthcare provider, and explore alternative treatment options if appropriate. In some cases, regenerative treatments such as platelet-rich plasma (PRP) therapy may be a safer and more effective treatment option for foot and ankle conditions. Also, of note, cortisone injections can not be administered near or in a tendon such as the achilles.



This is where PRP comes to play. PRP therapy can be a valuable treatment option for patients with Achilles tendonitis. By promoting the body's natural healing response, PRP injections can accelerate recovery time, reduce pain and inflammation, and improve overall function and mobility. If you are suffering from Achilles tendonitis or another foot or ankle injury, talk to your healthcare provider about whether PRP therapy may be right for you.



Platelet-rich plasma (PRP) Is A Game-Changer

Platelet-rich plasma (PRP) injections are a form of regenerative medicine that has gained popularity in recent years for treating a variety of orthopedic conditions, including foot and ankle injuries. PRP therapy involves the use of a patient's own blood, which is processed to concentrate the platelets and growth factors, and then injected into the affected area to stimulate healing.

In foot and ankle injuries, PRP injections can be used to treat a range of conditions, including plantar fasciitis, Achilles tendonitis, ankle sprains, and osteoarthritis. These injuries often result from repetitive stress, overuse, or trauma, and can be difficult to treat with traditional methods.

PRP therapy works by promoting the body's natural healing response. Platelets contain growth factors that stimulate the repair and regeneration of tissues, including bone, cartilage, and tendon. When injected into the injured area, the concentrated platelets and growth factors can accelerate the healing process and reduce pain and inflammation.

The PRP injection procedure is relatively simple and typically performed in an outpatient setting. The patient's blood is drawn and then processed using a centrifuge to separate the platelets from the other blood components. The concentrated platelets are then mixed with a small amount of the patient's own plasma and injected into the affected area using ultrasound guidance to ensure precise placement.

Patients may experience some discomfort or swelling at the injection site, but this typically subsides within a few days. The full effects of PRP therapy may take several weeks to months to fully manifest, and multiple injections may be necessary for optimal results.

PRP therapy is considered a safe and effective treatment option for foot and ankle injuries, with minimal risk of adverse effects or complications. As with any medical procedure, however, there are certain risks to consider, such as infection, bleeding, or allergic reaction. Patients should discuss the potential risks and benefits of PRP therapy with their healthcare provider before undergoing treatment.

In summary, PRP injections can be a valuable treatment option for foot and ankle injuries, offering a safe and effective alternative to traditional methods. By promoting the body's natural healing response, PRP therapy can accelerate recovery time, reduce pain and inflammation, and improve overall function and mobility. If you are suffering from a foot or ankle injury, talk to Board-Certified Foot and Ankle specialist, Dr. Sara Shirazi about whether PRP therapy may be right for you.





Injections for Ankle Arthritis

Supartz Injection




About Osteoarthritis (OA)

Osteoarthritis is a degenerative disease that can affect any joint in the body. For us, that includes the ankle joint, foot joints, and even toe joints. Being the most common form of arthritis, osteoarthritis affects millions of people around the world. Individuals in their mid-to-late forties tend to have a higher risk of developing osteoarthrosis. Physiologically, osteoarthritis is resulted from the stress on the joint, repetitive movements and wear and tear. The damaged cartilage in the joint will cause inflammation and pain. At the same time, it restricts the range of motion in the joints. Being a progressive condition, the symptoms of osteoarthritis tend to worsen over time. As the condition deteriorates, patients may find it hard to climb stairs, walk, or even stand. Thankfully, there are many treatment options for osteoarthritis, including prescription medications, steroid injections, custom molded orthotics, physical therapy, and lifestyle modification (e.g. weight reduction). Apart from that, viscosupplementation injectables such as Supartz or Synvisc are also used as for the symptomatic treatment of osteoarthritis.


As we get older, our joint fluid levels decrease, which can lead to joint pain. Fluid loss can also be caused by Osteoarthritis, which will not get better without treatment. While conservative treatments are the mainstay of treatment for osteoarthritis, they may not work on all patients. For patients who have not had success with these treatments, doctors may utilize viscosupplementation, as second-line treatment. Viscosupplementation is a treatment that has a cushioning effect on the joint.


Supartz is a viscosupplementation injectable commonly used in the management of osteoarthritis pain. Supartz is an injectable, which contains fluid with a gel consistency. Supartz is a synthetic fluid designed to match the fluids that surround joints in the body. The fluid within joints helps to absorb shock and keep the joints lubricated. Having shock-absorbing properties, the gel-like fluid allows smooth movements between the bones.


Supartz is formulated with hyaluronic acid (hylan G-F 20 and sodium hyaluronate), a compound that mimics the actions of a natural substance in the joint. It lubricates the joint, helping the bones to move smoothly. As a result, pain can be significantly reduced, and patient joint mobility is improved.

The injections are performed at our office by Dr. John. Using a needle, the Supartz injection is injected into the affected joint space. It typically takes a few minutes to complete the procedure. The duration of action can be lasting for approximately 6 months but can vary from patient to patient.


As with all viscosupplementation injectables, Supartz is designed for symptomatic treatment, meaning this is not meant for patients who do not have joint-related pain of the Foot or Ankle. They do not cure the underlying causes of osteoarthritis, nor do they regenerate the injured or degraded cartilage.


Who Should NOT Have A Supartz Injection?

Supartz is sourced from rooster combs; therefore, they should NOT be used in those with a known allergy to avian (bird) proteins, poultry, feathers, and/or egg products.

Anyone who has previously had any previous allergic reactions to Supartz therapy or similar material (hyaluronate products) should NOT have a Supartz Foot or Ankle joint injection.

Anyone with infections or skin diseases around the Foot or Ankle area should NOT have a Supartz Foot or Ankle injection.

If you are pregnant or lactating, we DON’T recommend that you have a Supartz Foot or Ankle injection, because its safety in pregnant/lactating women has never been studied.

You should also inform us if you have any blood clots or circulation problems in the legs.

Supartz has not been approved for use on anyone under the age of 21.


How Many Supartz Injections Do I Need?

Supartz injection treatment is FDA approved for 5 weekly knee injections, but some patients report benefit from only 3 injections. (Some patients may experience benefits with as few as 3 injections given at weekly intervals. This has been noted in a study in which patients treated with 3 injections were evaluated for 90 days.) The number of required injections can vary in Foot and Ankle conditions when compared to the knee.

Dr. John believes the best protocol for Foot or Ankle injections is to perform a series of 3 weekly injections and then wait 4-6 weeks before determining whether or not you should have two additional injections. This protocol seems to provide the highest value for patients.


Post-Supartz Injection – After Care Recommendations

After receiving an injection, let the area rest for the next 48 hours. Try not to stand for longer than one hour at a time, and be sure to avoid strenuous activities such as running, jogging, or lifting weights.


What Are The Side Effects Of Supartz?

After injection, patients may experience temporary pain and swelling at the site of injection. However, these symptoms tend to be short-lived and self-limiting in nature.

The largest clinical trial injections involved a series of 5 knee injections. The pain was the most common side-effect. 18.4% of Supartz injection patients reported pain as did 16% of control patients. Another common side-effect was arthralgia (defined as joint pain with no evidence of inflammation). This occurred in 12.6% of Supartz recipients and 15% of controls.

Other reported side effects include:

  • Back pain: 11.5% of Supartz recipients, 12.5% of controls.

  • Headache: 3.4% of Supartz recipients, 5% of controls.

  • Injection site pain: 3.4% of Supartz recipients, 5% of controls.

  • Injection site reaction: 1.1% of Supartz recipients, 3.8% of controls.

In Summary

The progression of Ankle, Foot, and Toe osteoarthritis can lead to the inability to walk, stand, or even develop difficulty wearing shoes. This can significantly disrupt the daily functioning of patients. Current treatment modalities often can be used to manage the condition. Unfortunately, they do not always work. Being the second-line treatment of osteoarthritis, viscosupplements such as Supartz effectively reduce pain, providing lasting symptomatic relief. While there is currently no cure for osteoarthritis, it is possible to relieve its associated symptoms and slow the progression of the disease.


Supartz vs. Synvisc: how are they similar and different?

Both Supartz and Synvisc are formulated with hyaluronic acid (or more specifically, hylan G-F 20 and sodium hyaluronate), a compound that mimics the actions of a natural substance in the joint. Having similar modes of action, they lubricate the joints, helping the bones to move smoothly. This subsequently reduces discomfort and pain. Supartz and Synvisc also have a similar duration of action, lasting for approximately 6 months. Synvisc seems to have equivalent efficacy to Supartz (neither of the injections is more superior to the other). Perhaps the biggest difference between the two formulations is number of injections required. Supartz is usually given in 3 to 5 injections consecutively. In contrast, Synvisc is typically given in 3 separate injections.


What are the side effects of Synvisc and Supartz?

Both Synvisc and Supartz have a similar side effect profile. After injection, patients may experience temporary pain and swelling at the site of injection. However, these symptoms tend to be short lived and self-limiting in nature. Synvisc and Supartz are sourced from rooster combs; therefore, they should not be used in those with a known allergy to avian proteins, feathers, and/or egg products.


The takeaway

The progression of ankle, foot, and toe osteoarthritis can lead to the inability to walk, stand, or even develop difficulty wearing shoes. This can significantly disrupt the daily functioning of patients. Current treatment modalities often can be used to manage the condition. Unfortunately, they do not always work. Being the second line treatment of osteoarthritis, viscosupplements such as Supartz and Synvisc effectively reduce pain, providing long lasting symptomatic relief. Supartz and Synvisc are equally effective in the symptomatic treatment of osteoarthritis. While there is currently no cure for osteoarthritis, it is possible to relieve its associated symptoms and slow the progression of the disease.


If you would like to see if you are a good candidate for these injections, please call Pasadena Orthopedics and schedule an appointment with board-certified Foot & Ankle surgeon, Dr. Sara Shirazi --- 626-517-0022.

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