Achilles Tendinopathy.

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Abstract

Conflict of interest statement: Disclosure: Miguel Medina Pabón declares no relevant financial relationships with ineligible companies. Disclosure: Usker Naqvi declares no relevant financial relationships with ineligible companies. 9. PM R. 2018 Dec;10(12):1385-1403. doi: 10.1016/j.pmrj.2018.05.007. Epub 2018 Jun 1. Effect of Shockwave Treatment for Management of Upper and Lower Extremity Musculoskeletal Conditions: A Narrative Review. Reilly JM(1), Bluman E(2), Tenforde AS(3). Author information: (1)Spaulding Rehabilitation Hospital, Charlestown, MA(∗). (2)Brigham and Women's Hospital, Boston, MA(†). (3)Spaulding Rehabilitation Hospital, 300 First Street, Charlestown, MA 02129(‡). Electronic address: atenforde@partners.org. Extracorporeal shockwave therapy (ESWT) is a technology that was first introduced into clinical practice in 1982 for urologic conditions. Subsequent clinical applications in musculoskeletal conditions have been described in treatment of plantar fasciopathy, both upper and lower extremity tendinopathies, greater trochanteric pain syndrome, medial tibial stress syndrome, management of nonunion fractures, and joint disease including avascular necrosis. The aim of this review is to summarize the current understanding of treatment of musculoskeletal conditions with ESWT, accounting for differences in treatment protocol and energy levels. Complications from ESWT are rare but include 2 reported cases of injury to bone and Achilles tendon rupture in older adults using focused shockwave. Collectively, studies suggest ESWT is generally well-tolerated treatment strategy for multiple musculoskeletal conditions commonly seen in clinical practice. LEVEL OF EVIDENCE: III. Copyright © 2018 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved. DOI: 10.1016/j.pmrj.2018.05.007