Shocking News About Achilles' Tendon Pain
Researchers at the Norfolk and Norwich University Hospital in the United Kingdom have some questions about shock wave treatments. These high-energy sound waves have been used for kidney stones. Now they are being used for some soft tissue conditions.

Can shock wave therapy relieve chronic Achilles' tendon pain? Does it improve the patient's general health? Does shock wave therapy change ankle motion? Can this kind of treatment result in tendon rupture?

In this study 49 patients with chronic Achilles' tendon pain were divided into two groups. Everyone had pain that got worse with activity and exercise. The treatment group had 1500 shocks three times (once each month for three months).

The control group had a placebo treatment. The same machine was used but bubble wrap was placed between the machine and the patient's skin. This dispersed the sound waves so none got through.

Everyone was followed for one year after the start of the study. The authors report no difference in results between the two groups. They say their results give no support to the use of shock wave therapy for chronic Achilles tendon pain. Two older patients (60-65 years old) in the treatment group had an Achilles' tendon rupture within two weeks of the first treatment. Shock wave therapy should be used with caution in this age group.
M. L. Costa, FRCS (Tr and Orth), et al. Shock Wave Therapy for Chronic Achilles Tendon Pain. In Clinical Orthopaedics and Related Research. No. 440. Pp. 199-204.