Efficacy of dexamethasone iontophoresis as treatment for insertional Achilles tendonitis.

Abstract

Dexamethasone iontophoresis has been used to treat insertional Achilles tendonitis with varying effects. This retrospective study evaluated the effectiveness of dexamethasone iontophoresis (DI) in patients with insertional Achilles tendinopathy (IAT) or retrocalcaneal bursitis. We analyzed 159 patients, of which 87 received three or more DI treatments. We compared first and last-visit pain scores, range of motion (ROM), and posterior heel spur size radiographic measurements. No significant differences between treatment groups were observed in pain or ROM (p-values >0.3). However, a substantial difference in posterior heel spur size was found, with more prominent spurs associated with more than three treatments (p-value = 0.019). Although not statistically significant, it was noted that increased spur size and Haglund bump height were linked to a higher likelihood of surgical intervention. This study suggests DI may provide short-term relief in IAT but does not significantly improve long-term functional outcomes. Radiographic analysis can guide treatment, particularly in more prominent posterior heel spurs. Further prospective research is needed to explore the long-term efficacy of DI in managing IAT.