Extracorporeal shockwave therapy for Achilles tendinopathy

Achilles tendinopathy is characterised by chronic degeneration of the Achilles tendon and is usually associated with injury or overuse. Symptoms include pain, swelling, weakness and stiffness over the Achilles tendon and tenderness over the heel. Achilles tendinopathy is classified as insertional or non-insertional. Insertional Achilles tendinopathy occurs at the bone–tendon junction in more active people, and non-insertional (or mid-portion) Achilles tendinopathy occurs more proximally in older, less active and overweight people.

Conservative treatments include rest, application of ice, non-steroidal anti-inflammatory drugs (NSAIDs), orthotic devices and splints, physiotherapy, Achilles tendon exercises or stretching, topical nitroglycerin, low‑level laser therapy and injections with corticosteroid or autologous blood. Surgery may rarely be considered in patients with refractory symptoms with the aim of repairing partial tears in the Achilles tendon.