Effectiveness of extracorporeal shockwave therapy versus conventional physiotherapy in treatment of chronic Achilles tendinopathy

Abstract Background Achilles tendinopathy (AT) is one of the most frequent overuse injuries in athletes. Extracorporeal Shock Wave Therapy (ESWT) has been proposed as an effective conservative treatment in chronic Achilles tendinopathy. Conventional physical therapy is also beneficial in the treatment of chronic Achilles tendinopathy. Aim of the Work To compare the effect of ESWT versus conventional physiotherapy (therapeutic ultrasound, LASER, deep friction massage) in the treatment of chronic AT, by using musculoskeletal ultrasound and other clinical parameters for assessment. Methods Thirty chronic AT patients were randomly divided in to two groups (15 per group): group 1 received ESWT and group 2 received conventional physical therapy for 6 weeks. Visual analogue scale (VAS), Victorian Institute of Sports Assessment-Achilles (VISA-A) questionnaire, American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hind foot scale were used to assess pain, function and physical activity. Ultrasonography was also used to assess the ultrasonographic findings in chronic AT. All patients were evaluated at baseline and after 6 weeks of treatment. Results Our study revealed that both ESWT and conventional physical therapy recorded highly significant VAS reduction and highly significant improvement in VISA-A and AOFAS after 6 weeks of treatment. Moreover, ESWT showed significant improvement in the tendon thickness and heterogenicity with no significant effect on calcifications or neovascularization. Conclusion ESWT and Conventional physical therapy are both effective in reducing pain, improving function and physical activity in chronic Achilles tendinopathy patients. Moreover, ESWT is superior to conventional physiotherapy in improving tendon thickness and heterogenicity with no significant effect on calcifications or neovascularization.