Extracorporeal shock-wave therapy in the management of chronic soft-tissue conditions

Tendinopathy—from basic science to treatment

“…56 Shock-wave therapy, which is thought to function on the tenocytes to stimulate repair, might be effective in a carefully selected group of patients, 57 although other studies have reported no significant effect. 58,59 Growth factors have been used for several years in an attempt to improve tendon healing, but there is currently no evidence that these are effective in tendinopathies. Nitric oxide, applied using topical nitroglycerin patches, has been shown to improve outcomes in randomized, double-blind, placebo-controlled trials, possibly by enhancing collagen synthesis.…”

Platelet-rich plasma injections for chronic plantar fasciitis

“…Although the effect of ESWT remains controversial, reliable evidence supports the use of this approach for treating chronic plantar fasciitis [12,18]. However, adverse effects such as pain during treatment, softtissue damage (bleeding, hematoma, paresthesia), nausea, the need for peripheral nerve block and costs should be considered when proposing this procedure [26].…”

Repetitive low‐energy shock wave application without local anesthesia is more efficient than repetitive low‐energy shock wave application with local anesthesia in the treatment of chronic plantar fasciitis

“…The characteristic complaints are knife-like pain at the calcaneal insertion of the medial part of the plantar fascia, typically worse on first arising in the morning, and often lasting months to years. Many treatment regimens exist but effectiveness is variable [8,52,55,63]. Multiple publications focused on the evaluation of a clinically relevant effect of shock wave application on plantar heel pain, either of high-energy extracorporeal shock wave treatment (ESWT), applied in a single session with local or regional anesthesia [3,6,9,28,35,36,38,59] or of lowenergy ESWT, applied repetitively without local anesthesia [1, 4,7,11,[20][21][22][23]27,[44][45][46]48,51].…”