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

June 30, 2023/0 Comments/in Vol 3 | Issue 1 | Jan June 2023/by Editor JRS

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, […]

Lateral Epicondylitis: General Concepts and Shock Wave Treatment Evidence

June 30, 2023/0 Comments/in Vol 3 | Issue 1 | Jan June 2023/by Editor JRS

Review Article | Volume 3 | Issue 1 | JRS Jun – June 2023 | Page 32-34 | Ricardo Kobayashi. DOI: 10.13107/jrs.2023.v03.i01.81 Author: Ricardo Kobayashi [1] [1] Pain Center, University of S£o Paulo, S£o Paulo, Brazil. Address of Correspondence Dr. Ricardo Kobayashi, MD, Phd, Pain Center, University of S£o Paulo, S£o Paulo, Brazil. E-mail: institutokobayashi@gmail.com […]

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

June 30, 2023/0 Comments/in Vol 3 | Issue 1 | Jan June 2023/by Editor JRS

Lateral Epicondylitis: General Concepts and Shock Wave Treatment Evidence

June 30, 2023/0 Comments/in Vol 3 | Issue 1 | Jan June 2023/by Editor JRS

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

June 30, 2023/0 Comments/in Vol 3 | Issue 1 | Jan June 2023/by Editor JRS

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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How to Cite this article: Terán PG, Lozada EA, LeMarie AS. | Achilles Tendinopathy, Pathophysiology, Diagnosis, and Management with Shockwave Therapy. | Journal of Regenerative Science | Jan – June 2023; 3(1): 26-31.

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Lateral Epicondylitis: General Concepts and Shock Wave Treatment Evidence

June 30, 2023/0 Comments/in Vol 3 | Issue 1 | Jan June 2023/by Editor JRS

Author: Ricardo Kobayashi [1]

[1] Pain Center, University of S£o Paulo, S£o Paulo, Brazil.

Address of Correspondence
Dr. Ricardo Kobayashi, MD, Phd,
Pain Center, University of S£o Paulo, S£o Paulo, Brazil.
E-mail: institutokobayashi@gmail.com

Abstract

Introduction:Lateral epicondylitis (LE) is one of the most common tendinopathies of the upper extremity characterized by lateral elbow pain, seriously affecting patients’ daily life and work.
Pathophysiology: Anatomically, the common extensor insertion on the lateral epicondyle of the humerus, mostly the extensor carpi radial is brevis tendon insertion, undergoes microtearing associated with a chronic repair process, but hardly any inflammation. The pathoanatomy of overuse tendinopathy is non-inflammatory angiofibroblastic tendinosis. For this reason, the term ‘‘tendinitis’’ is avoided, and ‘‘tendinosis’’ is preferred.
Diagnosis: LE is primarily a clinical diagnosis. The natural history is a gradual onset of pain in the absence of defined trauma. The most
common findings on physical examination are tenderness at the lateral epicondyle of the distal humerus and weakness or pain with resisted wrist extension (the Thomsen test).
Treatment: Non-surgical options are the mainstream treatment for LE, a small proportion of patients eventually undergoes surgery, although surgery for LE is no more effective than non-surgical treatment, based on evidence. Non-operative treatments including rest, application of ice, administration of analgesic medications, orthopedic devices, ultrasound, transcutaneous electrical nerve stimulation, eccentric training, and extracorporeal shock wave therapy (ESWT).
Shockwave Treatment of LE: There are many therapeutic options for treating LE. The existing evidence does not clearly support the efficacy of any of the available treatment methods for this clinical condition. ESWT is not the exception, although it was approved by the U.S. Food and Drug Administration for treating this disease in 2002 and much of the current evidence supports its indication for LE..

Keywords: Lateral epicondylitis, Tennis elbow, Tendinopathy, Shock waves.

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How to Cite this article: Kobayashi R. | Lateral Epicondylitis: General Concepts and Shock Wave Treatment Evidence. | Journal of Regenerative Science | Jan – June 2023; 3(1): 32-34.

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

Lateral Epicondylitis: General Concepts and Shock Wave Treatment Evidence

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Lateral Epicondylitis: General Concepts and Shock Wave Treatment Evidence

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