From the Research
Treatment for peroneal tendonitis should initially focus on conservative management, including rest, ice, anti-inflammatory medications, and physical therapy, with consideration of corticosteroid injection or surgery for persistent cases, as supported by the most recent study 1. The goal of treatment is to reduce pain and inflammation, promote healing, and improve function. Key components of conservative management include:
- Reducing activities that cause pain
- Applying ice to the affected area for 15-20 minutes several times daily
- Using over-the-counter NSAIDs like ibuprofen (400-800mg three times daily with food) or naproxen (220-440mg twice daily) for 1-2 weeks
- Engaging in physical therapy to focus on stretching and strengthening exercises for the peroneal tendons and surrounding muscles
- Wearing supportive footwear with proper arch support or custom orthotics to correct biomechanical issues In some cases, a walking boot or ankle brace may be recommended for 2-4 weeks to immobilize and protect the tendons. For persistent cases, a corticosteroid injection may be considered, though this is used cautiously due to potential tendon weakening, as noted in the study 1. Surgery is rarely needed but may be considered for severe cases that don't respond to conservative treatment after 3-6 months, with operative treatment being effective in allowing patients to return to work, but only half of patients being able to return to sports 2. Most patients recover fully with proper conservative management within 6-12 weeks, though gradual return to activities is important to prevent recurrence.