Achilles Tendinopathy, Pathophysiology, Diagnosis, and Management with Shockwave Therapy

Review Article | Volume 3 | Issue 1 | JRS Jun – June 2023 | Page 26-31 | Paul German Terán , Estefania Anabel Lozada , Alvaro Santiago LeMarie.
DOI: 10.13107/jrs.2023.v03.i01.79

Author: Paul German Terán [1], Estefania Anabel Lozada [1], Alvaro Santiago LeMarie [2]

[1] Department of Traumatology and Orthopedics, Orthopedic Specialties Center, Quito, Ecuador,
[2] Anatomy Professor, Faculty of Medicine, International University of Ecuador.

Address of Correspondence
Dr. Paul German Terán,
Department of Traumatology and Orthopedics, Orthopedic Specialties Center, Quito, Ecuador.
E-mail: paulteranmd@gmail.com

Abstract

The Achilles tendon is a strong structure that is frequently injured in runners and jumpers, but it can also be present in patients who do not engage in any sports. This clinical syndrome is characterized by pain, structural changes, and impairment of physical function. Achilles tendinopathy is extensively studied because it can be devastating, with slow and prolonged recovery that can take a year or more, and a high risk of re-injury. This condition is classified into insertional and non-insertional Achilles tendinopathy, depending on the affected region of the tendon. Intrinsic and extrinsic factors contribute to the intratendinous changes in vascularization and elevated pain neurotransmitters. The diagnosis is primarily based on the patient’s clinical history, and imaging techniques such as ultrasound, including sonoelastography, and magnetic resonance imaging can be useful in identifying the nature, location, and extent of the lesion. Treatment options for Achilles tendinopathy include rehabilitation, image-guided injections, shockwave therapy, ultrasound therapy, percutaneous intratissue electrolysis, orthotics, medications, and surgery. Among these options, shockwave therapy may provide the best tolerance, pain relief, and functional recovery.

Keywords: Achilles tendon, tendinopathy, insertional, non-insertional, extracorporeal shock waves.

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