Extra corporeal shockwave therapy (ESWT), ankle, elbow, heel, hip, shoulder (not routinely commissioned)

For the treatment of

Musculoskeletal conditions including Localised Tendonitis, Lateral Epicondylitis (tennis elbow), Achilles Tendinopathy (ankle), Plantar Fasciitis (heel), Trochanteric Bursitis (hip), Calcific Tendonitis (shoulder).

Commissioning position

This intervention is not commissioned and therefore should not be routinely offered to patients. Application for funding approval can be made, using the IFR process, by the clinician recommending the intervention, if their assessment is that there are exceptional reasons why their patient could benefit from it.

Summary of rationale

Ankle

NICE IPG571
The evidence on extracorporeal shockwave therapy (ESWT) for Achilles tendinopathy raises no major safety concerns.
Current evidence on efficacy of the procedure is inconsistent and limited in quality and quantity.

Elbow

NICE IPG313
The evidence on extracorporeal shockwave therapy (ESWT) for refractory tennis elbow raises no major safety concerns; however, current evidence on its efficacy is inconsistent.

Heel

NICE IPG311
The evidence on extracorporeal shockwave therapy (ESWT) for refractory plantar fasciitis raises no major safety concerns; however, current evidence on its efficacy is inconsistent.

Hip

NICE IPG376
Evidence on the efficacy and safety of extracorporeal shockwave therapy (ESWT) for refractory greater trochanteric pain syndrome is limited in quality and quantity.

Shoulder

NICE IPG742
Evidence on the safety of extracorporeal shockwave therapy for calcific tendinopathy in the shoulder shows no major safety concerns in the short term.
Evidence on efficacy is inadequate.