Extracorporeal shockwave therapy: a review.

Area of Science:

• Orthopedics
• Physical Medicine and Rehabilitation
• Biomedical Engineering

Background:

• Extracorporeal shockwave therapy (ESWT) has been utilized for tendinopathy treatment since the early 1990s.
• The precise mechanism of pain relief in tendinopathies via ESWT remains unclear.
• A growing body of evidence suggests ESWT efficacy in patients with persistent, treatment-resistant tendinopathies.

Purpose of the Study:

• To evaluate the effectiveness of ESWT for chronic tendinopathies.
• To synthesize evidence from randomized controlled trials (RCTs) on ESWT for tendinopathies.
• To identify areas requiring further research in ESWT protocols for tendinopathies.

Main Methods:

• Systematic review and analysis of randomized controlled trials (RCTs).
• Focus on studies involving patients with failed conservative or nonsurgical treatment.
• Comparison of ESWT against placebo ESWT or other conservative measures.

Main Results:

• RCTs indicate ESWT is superior to placebo for chronic tendinopathies of the shoulder, elbow, and heel.
• Positive results are consistent in individuals who have not responded to prior conservative therapies.
• ESWT demonstrates strong evidence as an effective therapy for chronic, treatment-resistant tendinopathies.

Conclusions:

• ESWT is a viable therapeutic option for chronic tendinopathies refractory to conventional treatments.
• Further research is necessary to optimize ESWT parameters, including energy levels, dosage, and session frequency.
• Standardization of ESWT protocols is needed to maximize patient care benefits.