Cause, clinical and ultrasound findings
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Extracorporeal shock wave therapy (ESWT) is used in Achilles tendinosis and in refractory tendinopathies and enthesopathies (plantar fasciitis, greater trochanteric insertion overload and lateral epicondylitis).
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It is also used in calcific tendonitis, most commonly in the shoulder but also in other locations.
Technique
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Acoustic shock waves are passed through the skin to the affected area under ultrasound guidance. Some machines allow the technique to be combined with fluoroscopic guidance.
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Often a series of treatments is needed. Local anaesthesia can be administered beforehand, as the treatment may be painful.
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The mechanism of the treatment is not well defined.
