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Shockwave Therapy – Audit 2015

Patients with chronic tendinopathy, who are medically insured, are often authorised to receive three sessions of shockwave therapy (ESWT). Previous experience indicates that this is often not the case, with patients often attending for only one or two sessions.


Number of patients who received three treatments of ESWT using OrthoPACE from Jan 2014-March 2015.
Standard set

There is no set standard, but a rate of 70% would seem a reasonable target.


I reviewed all my cases of shockwave therapy from Jan 2014 to March 2015, and identified those who had received at least three treatments of ESWT.


This was a retrospective study and a simple Yes/No method used to record the data. The results are listed below:

Total patients 93 Number who received 3 treatments (%)
Achilles Tendinopathy 15/29 (52%)
Lat. Hum. Tendinopathy 1/8 (13%)
High Hamstring Tendinopathy 0/10 (0%)
Patella Tendinopathy 3/20 (15%)
Plantar Fasciitis 4/26 (15%)


Many of my patients do not receive 3 sessions of ESWT, particularly those with lateral humeral tendinopathy, patella tendinopathy and plantar fasciitis. All my patients with high hamstring tendinopathy received only one or two sessions. The problems identi-fied were a lack of efficacy after the first treatment, and failure of medical insurers to cover treatments, especially in cases of high hamstring tendinopathy, and patella tendinopathy.

Changes recommended for 2015/2016 – audit results next year

Offer 3 treatments over 6 weeks ( i.e. one treatment every two weeks ) to try and in-crease patient compliance, especially in cases of achilles tendinopathy, as this condi-tion responds well. I had previously recommended one treatment, followed by a second treatment 3-6 weeks later, and perhaps a third session after another 3-6 weeks.
Lateral humeral tendinopathy does not respond to ESWT ( in my hands, anyway ). Only offer ESWT for this condition, if all else fails, recommending one treatment every two weeks.

- Dr Stephen Motto