Combined ESWT and RSW Therapy for Achilles Tendinopathy: A Prospective Study

Abstract

Introduction. Achilles tendinopathy is one of the most common overuse injuries of the foot and ankle in the active population. Many studies have shown radial sound wave therapy (RSW) or extra-corporeal shockwave therapy (ESWT) to be a safe and effective conservative treatment options when used independently. Methods. In this prospective study, we examined the outcomes of treatment on Achilles tendinopathy combining these two modalities. We hypothesize improved results with the combination therapy and compare this with previous studies. The current study observes a cohort of 24 patients, who received the both treatments with mean age of 47.2±12.8 years at the time of study. Each patient received three treatments initially and then subsequent treatments at 6 and/or 12 week follow up. Results. Pre-treatment VAS score was 6.3±1.3 and RM score was 3.5±0.5. Ultimately, these were reduced to 1.2±1.6 (P=0.00001) and 1.6±0.9 (P=0.00001) respectively at 17±4.5 month follow-up. Patients with paratendinosis had better outcomes than insertional Achilles pathology. Conclusions. Our results show a significant improvement in outcome measures in patients treated with ESWT and RSW, as compared to other studies. We conclude that the dual treatment method is a safe and improved method of treatment for Achilles tendinopathy compared to isolated use of ESWT or RSW.