Radial Extracorporeal Shockwave Therapy (rESWT) Is Not Superior to "Minimal-Dose" rESWT for Patients With Chronic Noninsertional Achilles Tendinopathy: A Double-Anonymized Randomized Controlled Trial.

Abstract

Outcomes following radial extracorporeal shockwave therapy (rESWT) in patients with chronic noninsertional Achilles tendinopathy are investigated. Patients with chronic noninsertional Achilles tendinopathy were recruited from a single National Health Services clinic, randomized equally to either "therapeutic" or "minimal-dose" ("presumed sham") rESWT (3 sessions at weekly intervals). Both groups had an identical structured home rehabilitation program of progressive loading, balance, and stretching exercises. Fifty-seven 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 patient-reported outcome measures for both groups, with "average pain" improving by 34% at 6 months. No consistent benefits were seen in global function, activity levels, or mood. "Recommended-dose" rESWT is not superior to "minimal-dose" rESWT and may be ineffective for patients with chronic noninsertional Achilles tendinopathy.