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

The trial was done at one private physiotherapy clinic and recruited mainly through social media and clinical networks, so it may not represent patients who are digitally isolated or not connected to those networks. The sham device was not truly inert; it was a machine held to the skin with no pressure, so the comparison is not a completely inactive placebo. The physiotherapists giving the treatment knew which group patients were in, although they used a script to reduce bias. The study did not measure other treatments participants may have used alongside the trial interventions. Some participants missed sessions: three in the sham group did not attend the second and third sessions, and one in the radial shockwave group did not attend the third. It only looked at immediate changes after each of three sessions, not longer-term outcomes.

The trial was funded by DJO Global, a company that sells shockwave therapy machines. The authors disclosed receipt of financial support for the research, authorship, and/or publication of the article.

Do not read the small before-after pain reduction as evidence radial shockwave works. Both groups also received exercise and education, and the primary outcome showed no difference between radial shockwave and sham.