Evidence for Shockwave Therapy

Achilles Tendonitis 

Eccentric Loading, Shock Wave Treatment, or Wait and See Policy for Tendinopathy of the main Body of Tendo Achilles. JD Rompe et al. Am J Sports Med 2007,Vol X,NoX,1-10

RCT level 1 evidence

75 patients with recalcitrant non-insertional Achilles tendonitis treated. At 4 months Shock Wave Therapy (SWT) and eccentric loading produced similiar results : Complete recovery/much improved in 52-60%. Wheras "wait and see" significantly less effective at 24%. Authors recommend SWT as alternative to surgery in recalcitrant patients and suggest eccentric loading combined with SWT .

Calcific Tendonitis of the Shoulder

Extracorporeal Shockwave lithotripsy for calcific tendonitis (tendinopathy) of the shoulder . NICE (National Institute For Clinical Excellence) Nov, 2003.

Current evidence on the safety and efficacy of extracorporeal shockwave lithotripsy for calcific tendonitis of the shoulder the use of the procedure appears adequate to support the use of the procedure. 

Link to NICE guidance on treatment with Shockwave therapy 

Greater Trochanter Pain Syndrome:

Jan D Rompe et al.  The American Journal of Sports Medicine, 2009, Vol. X, No. X, 1-10.
Comparison of single steroid injection, home training programme and radial shock wave therapy (3 sessions). Steroid injection gave best success rate (75%) but effects declined after 1 month. Shock wave therapy produced best results at 4 months (68%). At 15 months shock wave (74%) and home training programme (80%). (229 patients, level of evidence 2, randomised controlled trial)

Tennis Elbow:

Repetitve SWT for lateral elbow tendinopathy J.D.Rompe & N.Maffulli, British Medical Bulletin 1-24,2007

Meta-analysis of 10 Random Control Trials with 947 participants concluded the literature supports therapeutic benefit of SWT for chronic tennis elbow. They noted satisfactory results in 60% providing patient had chronic, and recalcitrant condition, using 2000 low energy impulses at weekly intervals for 3-6 weeks, no local anaesthesia and clinical focussing. Main benefit after 3 months.

Plantar Fasciitis:

L Gerdesmeyer et al.  The American Journal of Sports Medicine, 2008, Vol. 36, No. 11, 2100-2109, 2008.
Radial shock wave therapy significantly improves pain ,function and quality of life compared  to placebo in patients with recalcitrant plantar fasciitis.
61 % success rate compared to 42 % in placebo at 12 weeks. Even more pronounced superiority at 12 months
Level 1 Evidence. 245 patients in randomised, placebo controlled multicentre study.

Link to FDA approval of treatment with Shockwave therapy

Survey by EMS on Swiss Dolorcast found

83% of doctors rated treatment of tennis elbow as good or very good

90% of doctors rated treatment of plantar fasciitis as good or very good

87% of doctors rated treatment of Achilles tendonitis as good or very good

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