Therapeutic Ultrasound and Shockwave Therapy for Tendinopathy: A Narrative Review.

This is a narrative review, so it does not describe a systematic search, study selection, or quality appraisal. The studies use very different ultrasound pressures, frequencies, pulse modes, treatment durations, and follow-up times, so direct comparison is difficult. Many studies do not report the full acoustic pressure field or confirm device calibration, so the dose delivered to the tendon is often unclear. Placebo control is difficult for shockwave therapy because pain and treatment time differ between real and sham groups. Some positive clinical findings come from small trials with high dropout rates or no placebo comparison. Much of the mechanistic evidence comes from animal models, and the review says translation to humans is inconsistent. The review does not provide enough evidence to make specific recommendations for particular tendinopathies.

The supplied metadata lists U.S. government and NIH extramural research support. No separate conflicts-of-interest or author disclosure statement appears in the article text.

Do not conclude that therapeutic ultrasound or shockwave therapy reliably treats tendinopathy. The review reports mixed success, with many trials showing no benefit over placebo and no strong recommendation for any specific dose or tendon.