Surgical reconstruction is indicated if discomfort persists beyond six months; options include removal of the offending bone (Haglund's) with tendon debridement and repair for insertional tendonitis, and tendon debridement and repair for mid-substance disease; tendon transfer may be recommended in both situations.
Surgery to repair the tendon makes the tendon stronger and less likely to tear. It allows for mostly normal activity much sooner than immobilization.
Possible risks: temporary nerve damage, minor pain, minor risk of deep vein thrombosis and permanent nerve damage. All surgical treatments have a slight risk for bleeding and infection.