The effectiveness of shockwave therapy on patellar tendinopathy, Achilles tendinopathy, and plantar fasciitis: a systematic review and meta-analysis
Summary
This systematic review evaluated the effectiveness of shockwave therapy for patellar tendinopathy, Achilles tendinopathy, and plantar fasciitis. The study found negligible effects for patellar and Achilles tendinopathy but significant benefits for plantar fasciitis in both short and long-term outcomes.
Key Findings
"There is low-moderate evidence that ESWT has a negligible effect on pain and function for PT and AT. However, high-quality evidence suggests ESWT has a large effect on pain and function for PF."
"Both fEWST and rESWT will probably give similar results on pain and function outcomes for PF."
"ESWT can be provided as primary treatment for patients with PF."
Treatment Categories
Patellar Tendinopathy
low effectivenessESWT or ESWT + eccentric exercise shows negligible effects on pain and function compared to placebo or placebo + eccentric exercise in the short term. However, ESWT significantly affects pain compared to conservative treatment.
Specific Findings
ESWT has a negligible effect on pain and function in the short term compared to placebo or placebo + eccentric exercise
Low to moderate-quality evidence from meta-analysis
Patient Type
Athletes
Shockwave Type
Both focused and radial ESWT studied
Protocol
Outcomes
Limitations
Short-term follow-up only, limited number of studies
Achilles Tendinopathy
low effectivenessESWT shows small inconclusive effects on pain and function compared to eccentric exercise. Placebo outperformed ESWT in improving function but not for pain outcomes.
Specific Findings
ESWT had a small inconclusive effect on pain and function in the short term compared to eccentric exercise
Low-quality evidence from meta-analysis of five studies
Patient Type
General population
Shockwave Type
Both focused and radial ESWT studied
Protocol
Outcomes
Limitations
Vast variations in treatment protocols, primarily short-term assessment
Plantar Fasciitis
high effectivenessESWT shows significant improvements in both pain and function for plantar fasciitis in the short-term, mid-term, and long-term compared to placebo. Small inconclusive effects were found when compared to other treatments.
Specific Findings
ESWT has a large treatment effect for improving function in the short term and reducing pain in short, mid, and long-term
Moderate to high-quality evidence from meta-analysis of thirteen studies
Patient Type
General population (predominantly female)
Shockwave Type
Both focused and radial ESWT effective
Protocol
Outcomes
Limitations
Heterogeneity in protocols
Study Limitations
- Limited number of included studies in the analysis
- Only English and Chinese databases were searched
- Significance of heterogeneity could not be properly explained due to few included studies
