A Treatment Protocol for Achilles Tendinopathy with Extracorporeal Shockwave Therapy

Oral Extracorporeal Shockwave Therapy, or ESWT, is considered effective in at least tendinopathy treatment. There are various reports on the technique of radio ESWT without any consensus on the parameters. Here, we present a detailed treatment protocol for treating at least tendinopathy with using ESWT.

Recent developments in this field, focus on high-quality clinical research, and more accurate information, in order to define the optimal therapeutic options for each type of tendinopathy. Combining ESWT with other therapists, especially eccentric exercise, may finally enhance its effectiveness in improving patient outcomes and pain relief. To begin, place the patient in a comfortable prone position with the target area exposed.

After the physical examination, locate the area that requires treatment, and mark these points using a felt tip pen. Use the conductor, R15 for tendinopathy, and D20 for tendinopathy, and the trigger point of the deep muscle. After drying the skin thoroughly, apply an adequate amount of gel to the target area as a coupling agent.

To set up the device, press the power on or off button, or touch the liquid crystal display or LCD. Inspect parameter options on the display, and press the buttons directly on the LCD to make a selection. Adjust the parameters using the up and down buttons.

Press the pause or stop buttons located on the operator interface to stop the output. To edit the treatment screen and parameters, press the edit button, and wait for the edit treatment screen to display. Increase and decrease the parameters on the edit treatment screen, by pressing the up and down buttons as needed during the treatment process, based on the patient's tolerance and response.

Select the intensity to be used, which is 1.6 bar in this study. Starting at a lower intensity of the therapy, gradually increase the intensity as high as the patient can tolerate. Set the frequency of the treatment to about 10 hertz here.

Establish the desired number of shocks to be applied, which is 2000 in this study, and set the number of shocks per treatment within 800 to 3000. Begin the treatment by pressing the start button on the user interface, and activate the handpiece by pressing the trigger button on the handpiece. During the treatment, maintain the contact between the conductor and the skin tissue, and move the handle by drawing a small circle.

To pause the therapy at any time, press the pause button on the user interface, or the trigger button on the handpiece. To stop the therapy, press the stop button on the user interface. After the treatment, remove any residual coupling gel from the treated area.

Plan three sessions spaced one week apart. Outcomes of the treatment protocol applied to patients across both genders, showed a significant decrease in pain. The Roles and Maudsley score, which subjectively describes a patient's pain, also significantly decreased after the treatment.