What is Achilles tendinopathy?
Achilles tendinopathy is a condition affecting the Achilles tendon, the strong band of tissue at the back of the ankle that connects the calf muscles to the heel bone. It commonly develops due to overuse or repeated strain, leading to pain, stiffness, and swelling, particularly during walking, running, or first thing in the morning.
For some people, symptoms become long-standing and difficult to manage. The pain can interfere with exercise, work, and everyday activities. Achilles tendinopathy often co-exists with plantar fasciitis, as both conditions are linked to how load and stress are transferred through the foot and ankle.
In chronic cases, abnormal tiny blood vessels develop within and around the tendon. These vessels help sustain inflammation and are closely linked to ongoing pain.
What is Achilles tendon embolisation (ATE)?
Achilles tendon embolisation (ATE) is a minimally invasive, non-surgical treatment designed to reduce chronic pain caused by Achilles tendinopathy. It targets the abnormal blood vessels that drive persistent inflammation and pain in and around the tendon.
The procedure is usually performed as a day case under local anaesthetic with light sedation. A specialist doctor inserts a very thin catheter through a small blood vessel, typically from the groin, and carefully guides it to the blood supply around the painful area of the Achilles tendon. Tiny particles are then used to reduce abnormal blood flow, allowing inflammation to gradually settle.
The procedure typically takes around one hour, and patients go home the same day.
Important information
Who may be suitable for ATE?
Achilles tendon embolisation may be suitable for people who:
- Have chronic Achilles tendon pain lasting several months or longer
- Have not improved with physiotherapy, activity modification, or injections
- Experience pain that limits walking, running, or daily activities
- May also have co-existing plantar fasciitis
It can also be an option for patients who are not suitable for surgery or who prefer a non-surgical approach.
What are the benefits of ATE?
- Non-surgical treatment
- Targeted therapy addressing the source of inflammation
- Day-case procedure with no hospital stay
- Quick recovery with minimal disruption to daily life
- Preserves future treatment options, including surgery if needed
What is the success rate of ATE?
Achilles tendon embolisation has a high technical success rate, meaning the procedure can be safely completed in most patients. Many people experience meaningful pain reduction and improved function, often allowing a gradual return to normal activities and exercise.
As ATE is a relatively new treatment, research is ongoing to better understand long-term outcomes. Early clinical experience suggests encouraging results, particularly in patients with persistent symptoms.
What are the risks of ATE?
ATE is generally considered a low-risk procedure, especially when compared to surgical treatment.
Possible risks include:
- Temporary pain or soreness around the ankle or heel
- Bruising or mild bleeding at the catheter entry site
- Temporary numbness or nerve irritation (uncommon)
- Allergic reaction to contrast dye (rare)
- Infection (extremely rare)
Serious complications are uncommon when performed by experienced specialists.
How long is the recovery period?
Recovery following ATE is usually quick. Some patients experience mild discomfort or stiffness around the Achilles tendon for a few days to weeks.
Most people can:
- Walk the same day or next day
- Return to normal daily activities within a few days
- Gradually resume exercise over several weeks, guided by symptoms
Pain relief often develops gradually over weeks, rather than immediately.
Can ATE delay or avoid surgery?
Because Achilles tendon embolisation does not involve cutting or removing tendon tissue, it does not limit future treatment options. For many patients, it may help delay or avoid surgery, particularly when symptoms have not responded to other non-surgical treatments.