Steroid Injections May Not Help Achilles Tendinopathy
A new trial finds these injections offer no long-term benefits and may even increase pain in some patients after six months.
Updated on Oct. 29, 2026 in Arthritis
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A randomized trial of 192 patients found that high-volume injections, including those with corticosteroids, offer no long-term benefit for Achilles tendinopathy. While steroid injections provided brief early relief, they were linked to worse pain and disability at six months.
Why it matters
This study suggests that common injection-based interventions may not improve recovery for chronic Achilles pain over the long term. These findings are important for patients and clinicians evaluating whether the short-term benefits of steroids justify potential risks to tendon health.
This randomized controlled trial followed 192 patients over 12 months to compare corticosteroid injections, anesthetic alone, and sham injections. While the steroid group showed improvements at 6 weeks, those benefits vanished by 12 weeks, with worse clinical outcomes observed by 26 weeks.
The players
Research team in Melbourne, Australia
The group of clinicians who conducted this trial on injection therapies for Achilles tendinopathy.
The details
Researchers delivered treatments at the junction of the Achilles tendon and Kager's fat pad to target localized inflammation. The steroid-based arm utilized 25 mg of hydrocortisone, which initially reduced symptoms by modulating the local inflammatory response. However, the study observed that this effect was transient, and the steroid combination was eventually associated with increased pain and disability compared to other arms at the 26-week mark.
Timeline
6 weeks: Steroid patients reported short-term improvement in VISA-A pain scores.
12 weeks: The initial clinical advantage of the steroid treatment disappeared.
26 weeks: Patients in the steroid group experienced worse pain and disability.
52 weeks: Researchers completed the primary outcome assessments for the trial.
Health Landscape
This study updates the current evidence regarding high-volume injection therapies for chronic tendon conditions. It highlights a departure from using corticosteroid injections as a primary long-term management strategy for Achilles tendinopathy.
If you are experiencing persistent Achilles pain, these findings suggest that injection-based treatments may not be a definitive long-term solution. It is worth discussing these risks and potential alternatives with your physician before opting for steroid-based interventions.
The takeaway
Steroid injections for Achilles pain may provide only temporary relief and carry potential risks for long-term disability. Focus on discussing comprehensive, non-invasive rehabilitation strategies with your healthcare provider instead of relying on injections for chronic tendon issues.
Further reading
For more information on managing chronic joint and tendon pain, visit the Arthritis section.
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Would you prioritize short-term pain relief if it risked worse long-term health outcomes?
