# Does radial shockwave therapy lead to immediate improvements in pain in people with insertional Achilles tendinopathy? A randomised controlled trial

## TL;DR

This study found that radial shockwave therapy does not provide better immediate pain relief than a placebo for people with insertional Achilles tendinopathy.

## Contribution

The study provides new evidence that radial shockwave therapy is no more effective than a sham treatment for immediate pain reduction in this condition.

## Key findings

- Radial shockwave therapy showed no significant difference in pain reduction compared to the sham treatment.
- Both groups experienced similar improvements in movement-evoked pain after each session.
- Over half of the participants believed they were receiving the real treatment, indicating a strong placebo effect.

## Abstract

To investigate the immediate effects of radial shockwave therapy versus sham on movement evoked pain in people with insertional Achilles tendinopathy.

Randomised controlled trial.

Private clinic.

People diagnosed with insertional Achilles tendinopathy who were over 18 years old with a symptom duration of greater than 3 months.

Seventy-six participants (53% female, mean age 51 years) were randomly allocated to a radial shockwave (n = 38) or sham (n = 38) group. Three sessions of radial shockwave or sham (no pressure) to the most affected side in 5-to-10-day intervals. All participants received identical education and exercises.

The primary outcome measure was movement evoked pain (measured on a 100 mm visual analogue scale) at the first, second and third session immediately after each application.

There was 96% follow up of participants at the third session. Over half of the participants believed they were receiving the ‘real’ treatment (average 58%). The mean movement evoked pain scores improved each session by 0.6 points for the radial shockwave therapy and 0.7 points for the sham group. There was no difference between the groups after the first (−0.4, 95% confidence interval (CI) −1.6 to 0.8), second (0.4, 95% CI −0.8 to 1.6) or third session (−0.4, 95% CI −1.6 to 0.8).

In adults with insertional Achilles tendinopathy, radial shockwave therapy demonstrated no more efficacy than a sham in reducing immediate movement evoked pain. These results do not support the use of radial shockwave therapy for immediate pain relief among people with this condition.

ACTRN12620000035921.