Radial Extracorporeal Shockwave Therapy (rESWT) is not superior to “minimal-dose” rESWT for patients with chronic non-insertional Achilles tendinopathy; a double-blinded randomised controlled trial

Background

Investigating outcomes following radial-extra-corporeal-shockwave-therapy (rESWT) in patients with chronic non-insertional Achilles tendinopathy

Methods

Patients with chronic non-insertional Achilles tendinopathy were recruited from a single NHS clinic, randomised equally to either “therapeutic” or “minimal-dose” (“presumed sham”) rESWT (3 sessions at weekly intervals). Both groups had identical structured home rehabilitation programme of progressive loading, balance, and stretching exercises.

Results

57 patients were recruited; mean age 49.7±7.2 years, 60% female, symptom duration: 22.2±19.5 months. No between-group differences were identified at the final or any interim time-points. Clinically- and statistically-significant within-group improvements were identified in pain/local function PROMs for both groups, with “average pain” improving by 34% at 6-months. No consistent benefits were seen in global function, activity levels or mood.

Conclusion

“Recommended-dose” rESWT is not superior to “minimal-dose” rESWT and may be ineffective for patients with chronic non-insertional Achilles tendinopathy.