Achilles tendon pain is one of the most common overuse injuries in the foot and ankle [1,2],
affecting approximately 6% of the general population  and up to 9% of recreational runners
. In fact, Achilles tendon pain accounts for up to 18% of all running injuries . Treatment
protocols have historically included avoiding the activities that induced pain, orthotics or
inserts, over-the-counter pain killers, stretching exercises, and eccentric training to lengthen
the Achilles tendon . Although successful typically, these treatments can take several
weeks or months to take effect and may not work for everyone .
Several clinical studies have demonstrated the effectiveness of ESWT in treating Achilles tendon pain. In patients with chronic Achilles tendon pain, ESWT has demonstrated success at decreasing pain [6-9] and improving function [4,6,8,9] and these effects have persisted for up to a year . Although the exact biological mechanisms responsible for these improvements remain unknown, ESWT is thought to stimulate soft-tissue healing , enhance the formation of new blood vessels , modify pain reception , and modulate the production of growth factors and collagen .
1. Li HY, Hua YH. Achilles Tendinopathy: Current Concepts about the Basic Science and Clinical Treatments. Biomed Res Int. 2016;2016:6492597.
2. Chimenti RL et al. Current Concepts Review Update: Insertional Achilles Tendinopathy. Foot Ankle Int. 2017 Oct;38(10):1160-1169.
3. Pavone V, et al. Low-Energy Extracorporeal Shock-Wave Therapy in the Treatment of Chronic Insertional AchillesTendinopathy: A Case Series. Biomed Res Int. 2016;2016:7123769.
4. Rasmussen S. et al. Shockwave Therapy For Chronic Achilles Tendinopathy: A Double-Blind, Randomized Clinical Trial of Efficacy. Acta Orthop. 2008 Apr;79(2):249-56.
5. Scott A. et al. Conservative Treatment of Chronic Achilles Tendinopathy. CMAJ. 2011 Jul 12;183(10):1159-65.
6. Carulli C, et al. Effectiveness Of Extracorporeal Shockwave Therapy in Three Major Tendon Diseases. J Orthop Traumatol. 2016 Mar;17(1):15-20.
7. Furia JP. High-Energy Extracorporeal Shock Wave Therapy as a Treatment for Insertional Achilles Tendinopathy. Am J Sports Med. 2006 May;34(5):733-40.
8. Pavone V, et al. Low-Energy Extracorporeal Shock-Wave Therapy in the Treatment of Chronic Insertional AchillesTendinopathy: A Case Series. Biomed Res Int. 2016;2016:7123769.
9. Rompe JD, Furia J, Maffulli N. Eccentric Loading Compared With Shock Wave Treatment For Chronic Insertional Achilles Tendinopathy. A Randomized, Controlled Trial. J Bone Joint Surg Am. 2008 Jan;90(1):52-61.
10. Reilly JM, Bluman E, Tenforde AS. Effect of Shockwave Treatment for Management of Upper and Lower Extremity MusculoskeletalConditions: A Narrative Review. PM R. 2018 Dec;10(12):1385-1403.