Treatment approaches  for Achilles tendonitis or tendonosis are selected  on the basis  of how long  the injury has been present  and the degree of damage  to the tendon. In the early stage, when there is sudden (acute) inflammation, one  or more  of the following options may be recommended:

• Immobilization. Immobilization may involve the use  of a cast or removable walking boot  to reduce forces through  the Achilles tendon  and promote healing. 
• Ice.  To reduce swelling due  to inflammation, apply a bag  of ice over  a thin towel to  the affected area for 20 minutes of each waking hour. Do  not put ice directly against  the skin. 
• Oral medications.  Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may  be helpful in reducing  the pain and inflammation in  the early stage  of the condition. 
• Orthotics.  For those with over-pronation or gait abnormalities, custom orthotic devices  may be prescribed. 
• Night splints.  Night splints help to maintain  a stretch in the Achilles tendon during sleep. 
• Physical therapy.  Physical therapy may include strengthening exercises, soft-tissue massage/mobilization, gait  and running re-education, stretching, and ultrasound therapy.