Shockwave Therapy for Chronic Achilles Tendinopathy: A Double Blinded, Randomized Clinical Trial of Efficacy

Methods: Forty eight patients with chronic symptoms of Achilles tendinopathy for greater than three months, as diagnosed by clinical exam, voluntarily agreed to participate in the experimental study. Each patient was randomly assigned, by computer statistical system, to one of two treatment groups and underwent four treatment sessions once a week for four weeks. At the time of treatment each patient initially underwent a session of stretching and eccentric training before being given either active extracorporeal shockwave therapy (ESWT) or sham extracorporeal shockwave therapy (ESWT). Using Piezeson 100 at each session, 2,000 shots of radial shock waves at 0.12-0.51mJ/mm2, 50 Hz for the active ESWT group or 2,000 shots at 0mJ/mm2, 50Hz was delivered locally to the area of swelling and tenderness in the Achilles tendon. Outcome measures were based on the American Orthopaedic Foot and Ankle Society (AOFAS) score and overall subjective pain. These were assessed before treatment, during the four week treatment period, and at four, eight, and twelve weeks post treatment.