Journal of Pain Research (May 2017)
Healing of Achilles tendon partial tear following focused shockwave: a case report and literature review
Abstract
Yu-Chun Hsu,1,* Wei-Ting Wu,2,* Ke-Vin Chang,2–4 Der-Sheng Han,2–4 Li-Wei Chou5–7 1Department of Physical Medicine and Rehabilitation, Taipei Veterans General Hospital, 2Department of Physical Medicine and Rehabilitation and Community and Geriatric Research Center, National Taiwan University Hospital, Bei-Hu Branch, 3National Taiwan University College of Medicine, 4Community and Geriatric Research Center, National Taiwan University Hospital, Bei-Hu Branch, Taipei, 5Department of Physical Medicine and Rehabilitation, China Medical University Hospital, 6Graduate Institute of Acupuncture Science, College of Chinese Medicine, China Medical University, 7Department of Rehabilitation, Asia University Hospital, Taichung, Taiwan *These authors contributed equally to this work Abstract: Achilles tendinopathy is a common cause of posterior heel pain and can progress to partial tendon tear without adequate treatment. Effects of traditional treatments vary, and many recent reports focus on the use of extracorporeal shockwave therapy (ESWT) for Achilles tendinopathy but not for Achilles tendon partial tear. Here, we report the case of a 64-year-old female suffering from severe left heel pain for half a year. All treatment and rehabilitation were less effective until ESWT was applied. Each course of focused shockwave therapy included 2500 shots with energy flux density from 0.142 mJ/mm2 to 0.341 mJ/mm2. The visual analog scale decreased from nine to one degree. High-resolution musculoskeletal ultrasonography was performed before and 1 month after the treatment, which revealed healing of the torn region and decrease in inflammation. ESWT had shown to be an alternative treatment for Achilles tendon partial tear under safety procedure and ultrasound observation. Keywords: focused shockwave, Achilles tendon, partial tear, ultrasonography