Treatment of a Partial Achilles Tendon Tear using Focused Shockwave Therapy
Achilles tendinopathy is a common cause of posterior heel pain, swelling, and loss of function. It is caused by excessive loading-induced injury, degeneration, medications such as fluoroquinolones, or systemic disease. Running and jumping are the most frequent contributors, which still can be seen in sedentary individuals.
Degeneration and synthesis imbalance of the matrix that occurs with aging, overuse with repetitive wear and tear, or weight bearing movements can induce Achilles tendon pain.
Conventional treatments consist of rest, nonsteroidal anti-inflammatory drugs, stretching exercises, and eccentric training. The use of alternative treatments such as heat, electrical stimulation, massage techniques, steroid injections, and the use of platelet-rich plasma (PRP) have all been described as potentially useful non-surgical interventions.
Extracorporeal Shockwave Therapy (ESWT), also called Focused Shockwave Therapy, is a treatment modality that uses acoustic waves to stimulate blood flow and increase nutrient supply to an injured tissue thereby speeding up the healing process.
ESWT has been widely used for the treatment of calcific lesions and tendinopathies but not for Achilles tendon partial tears.
A case study in the Journal of Pain Research describes the use of Extracorporeal Shockwave Therapy (ESWT) on a 64-year-old female patient suffering from severe left heel pain for a period of 6 months. A high-resolution musculoskeletal ultrasound revealed a partial tear of the left Achilles tendon with surrounding inflammation. All the conventional treatments and rehabilitation exercises were ineffective in relieving her symptoms until ESWT was applied.
The entire duration of the treatment was 3 months with the first three sessions performed once every two weeks and the last five sessions done once a week.
A follow up ultrasonography one month after the treatment showed significant healing of the tear and a decrease in the surrounding tissue inflammation.
This study shows that ESWT can be a potential alternative treatment for partial Achilles tendon tears. More case studies over the next few years will provide more evidence of this promising therapeutic approach.
Healing of Achilles tendon partial tear following focused shockwave: a case report and literature review by Yu-Chun Hsu , Wei-Ting Wu , Ke-Vin Chang , Der-Sheng Han, and Li-Wei Chou.
