Efficacy of Extracorporeal Shock Wave Therapy in the Treatment of Achilles Tendinopathy: Clinical and Functional Outcomes

Aim: Chronic Achilles tendinopathy (AT) is one of the most common tendon pathologies, and conservative treatment often fails to produce satisfactory results. This study aimed to investigate the efficacy of extracorporeal shock wave therapy (ESWT) in chronic and refractory AT. Materials and Methods: A total of 195 patients who had undergone ESWT for AT refractory to standard conservative treatment were assessed retrospectively, and 64 patients (64 feet) who met our eligibility criteria were included. The patients underwent three sessions of ESWT, each with 2000 pulses at a dose of 0.06–0.12 mJ/mm2 (low-dose). Pain levels and clinical/functional scores were measured before the treatment (BT) and at the 3rd and 12th weeks of the last session, by using the Visual Analogue Scale (VAS) and the American Orthopedic Foot and Ankle Society (AOFAS) scoring system. Results: Of the 64 patients included, 48 were female and 16 were male. The mean patient age was 47.9 years. There was improvement in pain, the mean VAS scores changing from 7.4 (5–10) BT to 4 (2–7) at week 3 (p<0.001) and 1.5 (0–6) at week 12 (p<0.001). The mean AOFAS scores were also improved, changing from 60 (48–75) BT to 74.8 (62–90) at week 3 (p<0.001) and 86.6 (62–100) at week 12 (p<0.001). There was no statistically significant difference between male and female patients with respect to the improvement recorded in the VAS scores (p=0.163). Discussion and Conclusion: Low-dose ESWT can produce successful clinical results in the treatment of chronic AT refractory to standard conservative treatment