Extracorporeal shockwave therapy for Achilles tendinopathy: evidence review (treatmyachilles.com)

• ESWT is not superior to standard care (rest + exercise) but may be option for non-responders after 3 months.
• Evidence level is low to moderate; higher-quality research could change conclusions.
• Safety interval of at least 4 days between sessions; risk of rupture if used too frequently.

"Shockwave therapy is commonly used for Achilles tendinopathy, but current evidence shows it is not superior to standard treatment (relative rest and rehabilitation) in most cases. The evidence level is low to moderate. It may be considered for persistent cases when standard therapy has failed after at least three months. Caution is needed with acute inflammation, osteoporosis, and excessively frequent sessions due to risk of tendon rupture."