Misdiagnosed Achilles Tendonitis? Really A Nerve Pain Problem?

by David

I have had heel pain, in the back of the heel for over 6 months now. I am on the 2nd orthopedic surgeon who stated the mri showed minimal scarring of the achilles. I am 48 and fairly inactive, desk job. Doctor said therapy, etc.. would help. Nothing has helped, still in pain.

However, this is the part I don't understand. I do not have a sore heel. I don't get the "sore muscle " pain. I get nerve pain. It shoots hard at the back of my heel, hangs on for about 2-4 seconds, then leaves as fast as it came. Also, I have discovered that if i press my finger into my hamstring, or near my groin, I can cause the same pain in my heel anytime I want to..

Any ideas?

The doctor stated he was going perform an ultrasound to make sure nerves are mapping correctly? Are we on the right track that it could have been sciatic, or an l4, 5 situation?

I would appreciate any opinions on this.

Thank you for your time.


Joshua Answers:

Hey David. Thanks for asking.

Interesting. I have some thoughts, but let me ask a few questions first to make sure I'm on the right track.

1. Have you had this kind of pain previously of the past 6 months? Ever?

2. Is the nerve pain a 'ouch' pain like muscle soreness/ache/spasm, or a tingly, shocking/electrical, funny bone kind of thing? There's lots of variety of pain,please describe for me.

3. Were you actually diagnosed with Achilles Tendonitis. Doesn't sound like it's your issue, and I don't put much stock in diagnoses usually anyway, but it's good information. If so, what did the doctor say about it at the time?

4. What have you done for
it? Has anything helped? Has anything made it worse?

5. Any health issues?

6. Can you press anywhere in the leg and get that response, or are there just certain spots?

7. How and when does this nerve pain show up? How long does it last? Does it hurt at night in bed?

Ultrasound to see if nerves are mapping right.....that doesn't even make sense to me. I'll leave it at that, and just say that my opinion is that it would be a waste of your time, unless the doctor is looking for tumors or Deep Vein Thrombosis or some other medical danger.

Tendonitis has it's own predictable and reliable set of symptoms and complaints. Doesn't really sound like you have that.

See: What Is Tendonitis?

Little bit of scar tissue on the Achilles Tendon? Shrug. Only a problem if it's a problem.

My first thought is that this nerve pain is due to nutritional deficiency. If so, it will just be a matter of getting your specific levels up.

I'll say more about that later once you give me more clues.

Please reply using the comment link below. Do not submit a new submission to answer/reply, it's too hard for me to find where it's supposed to go.

And, comments have a 3,000 character limit so you may have to comment twice.

Joshua Tucker, B.A., C.M.T.
The Tendonitis Expert

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Comments for Misdiagnosed Achilles Tendonitis? Really A Nerve Pain Problem?

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Jan 01, 2010
Nerve pain too
by: Anonymous

I also have the same nerve pain as David. I have never had any tendon problems and have done nothing to inflame the area.

What were your suggestions for treatment?



Joshua Comments:

Hello Roberta.

The safe palce to start to cover one's bases and see the results of, is:

1. Magnesium taken as described on the page that link.

2. Get your Vitamin D level checked. Then get your Vitamin D level UP with Vitamin D3 (not D2).

3. Vitamin B6. If you have inflammation, Inflammation Causes Vitamin B6 Deficiency.

B6 deficiency can causes Carpal Tunnel Symptoms. It can certainly be a player in other nerve/muscle kind of issues.

4. Vitamin B12 (methylcobalamin, not cyanocobalamin). Safe and effective dosage to get one's level up, as shown by a variety of research studies, is 1,500-2,500mcg (mcg, not mg) per day. If that doesn't help after two weeks, then that's not the problem.

B12 is a big player in nerve pain, peripheral neuropathy, etc.

Get those bases covered. Please keep us updated and let us know what you do and what the results are.

Mar 30, 2013
Sounds much like me
by: Linda

A month ago I developed a numb feeling on the outside of my right foot. There is a spot just to the side of my Achilles about 5 inches up which if I press on it, I get a tingly feeling right in the area of the numbness. I was checked for D3, B12 and had a spinal xray. Doctor is quite puzzled. To complicate things, I have a similar sensation on the left foot but milder.


Joshua Comments:

What's your Vitamin D level, in 'ng/ml'?

Aug 15, 2015
Heel Pain not much during running or jumping
by: Anonymous

Similar symptoms here. Don't feel it much during running or jumping. If I sit on chair and extend the leg to straight while flexing my toes back towards me I get brief sharp pain.

Doesn't seem muscular or tendon related. No pain when doing calf raises etc.

Aug 13, 2016
by: Anonymous

I'm so glad I read this! I can lightly brush my heel and cause pain shooting up my calf and even up through my hamstring area.

Just started a week ago. It's the equivalent to having a sensitive tooth but it's MY LEG. it's awful. I've been treating achilles tendinitis for over a year. (Graston) At least that's what I assume it is.

Could this really be a deficiency in nutrition? I'm on the verge of going to a neurologist.


Joshua Comments:

Hi AnonyWow.

Yes, it really could be, whether it's a primary or secondary factor.

Pretty easy to find out.....

I'm be curious what a neurologist would say about it after examination.

And, no symptom like that when getting the Graston?

Aug 14, 2016
by: Anonymous

I've had ACL replacement, gout,and a few calf injuries. I also have flat feet, and hate wearing my $300 insoles. I formed a large bump on my achilles.

All indication of tendonitis.

So I've had my therapist work on it using Graston. I'm not too sure it's helped much, and it's very painful treatment. This new nerve pain is brand new. It truly feels like when there's an exposed tooth nerve being hit with cold water... but it's MY LEG! I'm going to buy B12 and Cal Mag and see if it helps. BUT, I'm skeptical that's all it is.


Joshua Comments:

DO NOT GET cal/mag. You'll end up taking too much calcium. Get a magnesium only supplement. NOT magnesium oxide.

Where all is the graston therapist working?

Mar 12, 2017
Nerve and Achilles from the heel
by: Shepard

Since Nov 2016 I've had a nerve condition behind my achillis that has sent me to ER on multiple occasions. It has gotten worse to the point that I rarely walk now. When "it" hits me the pain is such that I'd be happier without a foot.

I was sent to WVU ER in Jan 17. For ten hours on 5 minute intervals, the shock would come and last for about 30 to 60 seconds. Worst day of my life.

Docs are stumped. I've seen neurologist and foot ankle ortho. UVA is helping w pain mgt and NSAID and neurontin. It only is better if I'm off it. I was very active at 46 running and playing basketball.

My life has been taken from me. I live in constant fear because the pain in off the charts.

I get a lot of nerve flashes in the posterior tibial nerve and behind the achillis. I can't remember injuring it.

Funny, I started taking 1000 my of magnesium Malays and b5 to get rid of faciitis. It got rid of the fasciitis in two weeks and then I had PT for months.

I didn't realize I had magnesium in two other supplements I was taking. I was not taking calcium.

Funny that the plantar fac disappeared the same time this new problem showed up? I've been reading about "grief of the people" on IRUNFAR???

Man I need help. I'm depressed and am so afraid of the pain that I stay with my parents or friends. I'd rather die or cut my foot off than live with the pain. Lucky that it hasn't returned since Jan17, but I walk very little and on the mess...it's still there though.

Doc says it's not RSD thank God. It's only my left foot that I had two surgeries on in 1999.

But at times, my R foot burns on the post tib nerve. Had MRI yesterday...no word yet.


Joshua Comments:

Hi Shepard.

So you had two surgeries on your left side but this nerve pain is on the right side?

Let me know what the MRI results show, and I'll respond in full then.

Sep 05, 2017
Lot of same problem no answers
by: Evil

I have the same pain back of my foot above the heel. Excruciating pain. Ihightop shoes are almost unbearable. It gets red and hot.

Physical therapist said it's not tendinitis, chiropractor says it's from the l4 or L5 as I have had back problems almost my whole life nothing between the bones of my spine.

I will try magnesium and B vitamin and hope that one of us gets an answer.


Joshua Comments:

What did the PT think it was then?

If it was from a compressed l4-l5 issue, you'd (almost certainly) have other symptoms over a larger area, like numbness/tingling in the foot, numbness/pain in the leg, etc.

In other words, it's very unlikely that you'd just have burning inflamed heel pain from a compromised nerve/nerve root at l4-l5.

I'd definitely start that nutrition, for all the reasons you should.

And, there are multiple factors at play especially if you're in such an acute state. These same factors explain why your back is where it's at.

And nutrition is a primary factor so doing that will play a beneficial role in your back and foot/heel.

I of course think you should get and start on the Reversing Achilles Tendonitis program, so you'll start reversing all the factors causing that heel pain/inflammation.

Sep 06, 2017
Solved my problem
by: Linda

I posted back in 2013 with weird referred pain that was in both feet & legs. An MRI showed nothing and I was referred to a neurologist.

Before going that route, I went to my acupuncturist who is also a trained massage therapist. She discovered I had very tight muscles (gluteus medium area) in both hips.

I started working on the tight spots by massaging on a tennis ball, then worked up to a lacrosse ball. Within a month, the sensations were better and within 3 months, virtually gone.


Joshua Comments:

Yep, not surprising. Awesome!

Nutrition etc is likely still be a factor, but you just discovered some of the simple basics of how the body works: tight muscles can/do compress nerves. Remove the tightness, the compression (and symptoms of compression) goes away.

Aug 21, 2018
Weirdheel pain
by: P c

Been experiencing right lateral heel pain (sharp shooting n piercing type) and decreased sensation over the same area. It comes when I stretch my leg and dorsiflex at the same time.

It first started 6 months back and became severe in a week. I stopped all my activities and it gradually subsided.

Now it’s back again and there’s is so much burning.

I do a lot exercise plus walking In general. The Tibialis Anterior is also little tender. FYI ankle X-ray is normal . I have had back issues l5-s1 sacralization and L4-l5 disc prolapse but this pain is little different. It’s bothering me a lot.

I have super tight hamstring and gastrocnemius and it hurts a lot when I try to disown dog pose. Any guidance would help. Worst part is I feel little bit on left heel area as well.


Joshua Comments:

Hi Pc.

Probably most of that is from your lower back. Tightness causes compression...which compresses muscle and nerve and thus issues down the leg (tightness, nubness, etc.

I'd definitely see: Magnesium For Tendonitis

Lack of magnesium causes tightness, and tightness eats up magnesium...so you get stuck tight and stretching and massage don't help much, etc.

That's place #1 to start.

Aug 22, 2018
Lateral heel pain
by: Pc

Thank you so much! I have SI joint pain and pelvic level inequality post delivery (2 pregnancies) - pelvis upslip plus torsion as well that just refuses to go and recently diagnosed mild Scoliosis.

What caused what is still questionable esp some ortho asking me to go 1 inch shoe lift and physios telling me not to go as it’s because of muscle imbalances.

But pain n discomfort and tightness still remains plus this new nerve symptom.


Joshua Comments:

Hi Pc.

1. A good PT should be able to show you how to keep your hips balanced/stabilized (some or even a [depending] specific isometric exercise[s], basically).

And if a good enough PT, same thing to stabilize or reverse the scoliosis (for 90+% of people, it's not a disease it's just the predictable result of muscle imbalances).

2. I hate the 'shoe lift' thing. It's utter admission that the guy/gal has zero idea why you're having problems or how to fix it. "Oh, you have a big hole in your gut and you're bleeding? Huh. Well, here, let's put a bandaid on it, ta da problem solved!"

Your issue isn't as bad as a gunshot, obviously, but you get my point.

3. You may or may not be hosed due to the pregnancies and relaxin-caused lengthened ligaments. The only way to know for sure is to find said really good PT, get stabilized etc, stay stablized for a while (by doing the exericises etc), and seeing what happens/reassessing down the line.

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