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Extracorporeal Shockwave Therapy

A Review

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Abstract

Extracorporeal shockwave therapy (ESWT) has been in use for the treatment of tendinopathies since the early 1990s. The exact mechanism by which ESWT relieves tendon-associated pain is not known; however, there is an increasing body of literature that suggests that it can be an effective therapy for patients who have had repeated nonsurgical treatment failures. The highest strength of evidence is shown in randomised controlled trials, of which there are a small number. Reported results for tendinopathies of the shoulder, elbow and heel have shown consistent positive results in favour of ESWT over placebo ESWT in individuals who have failed conservative therapy. These studies provide strong evidence for ESWT as an effective therapy for the treatment of chronic treatment-resistant tendinopathies. There is still much debate over several issues surrounding ESWT that have not been adequately addressed by the literature: high- versus low-energy ESWT, shockwave dosage and number of sessions required for a therapeutic effect. Further research is needed to ascertain the most beneficial protocol for patient care.

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The authors did not receive grants or outside funding in support of their preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct any benefits to any research fund, foundation, educational institution or other charitable or nonprofit organisation with which the authors are affiliated or associated.

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Chung, B., Preston Wiley, J. Extracorporeal Shockwave Therapy. Sports Med 32, 851–865 (2002). https://doi.org/10.2165/00007256-200232130-00004

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