The effectiveness of shockwave therapy to improve pain and symptom severity in patients with chronic patellar tendinopathy: a literature review

Abstract

Background Patellar tendinopathy is a very common and debilitating condition that affects the anterior aspect of the knee. This review aimed to determine the effectiveness of shockwave therapy on pain and symptom severity for all types of patients with chronic patellar tendinopathy. Methods A search for quantitative primary studies was conducted, using the Allied and Complementary Medicine Database (AMED), Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, SPORTDiscus, Physiotherapy Evidence Database (PEDro) and the Cochrane Database of Systematic Reviews (CDSR) databases. Investigation of grey literature sources, Google Scholar and manual citation searching also took place. All searches were completed between 1 and 8 January 2022. Papers were included if the patients' symptoms were chronic (lasting 12+ weeks); any dose, method and type of shockwave therapy were also accepted. Results A total of six articles were accepted following screening, all published after 2010. This review included a total of 270 patients, of which 145 received shockwave therapy. Overall, the methodological quality of the six papers was moderate to low. Despite this, and the variation in application of shockwave therapy, the results demonstrated improvements in both pain and symptom severity outcome measures. Conclusions Shockwave therapy was effective in improving patients' pain and symptom severity, although more high-quality research trials are needed to investigate the effects of this therapy. The clinician's first line of treatment for patellar tendinopathy should be education and exercise; however, if this fails, shockwave therapy should then be considered.