What is the best treatment for plantar fasciitis, tennis elbows, achilles tendinopathy, ITB, glute med (lateral hip pain), etc ?

Over the past >25 years, I have helped countless people with tendon problems. But new research and new technology can be game-changing.

A client of mine asked me about shockwave therapy. I have used shockwave before when I worked at HFRC-Nedlands, but is it the game-changing machine?

Now, in my Physio clinic here in Joondalup, I have an Ultrasound combination machine with electrotherapy and a TENS machines.

Over the years, I have also learned additional treatment options for plantar fasciitis, tennis elbows etc (tendinopathies): Dry needling and specific home exercises are reducing pain and improving function, in clients with these problems. (Including Dupuytren’s contracture.)

The question is, has the gold standard changed?

Is it justifiable to invest over $20,000 into a shockwave machine or $4,000 to $6000 into a Laser machine?

https://www.medicalsearch.com.au/chattanooga-mobile-shockwave-therapy-unit/p/159789

Firstly what does the latest research say?

What is the best treatment for these tendon problems?   

Comparison of 3 treatment options for Therapy for Treatment of Plantar Fasciitis

Reference link

All 3 groups improved significantly, the thickness of the plantar fascia had decreased.

The treatment success rate was:

Laser and Shockwave therapy proved significantly superior to US therapy.

Hence, Laser is the best treatment option for tendinopathy?

A randomised controlled study is good; however, they only had 60 patents or 20 per group.

https://www.astiraustralia.com.au/electrotherapy-tens/laser-therapy/astar-physiogo-lite-laser.html

The results of another study with a similar patent group:

Comparing shockwave therapy to ultrasound therapy and home exercise therapy on pain, fatigue, performance and walking distance in women with plantar fasciitis.

Ultrasound and exercise therapy for patients with plantar fasciitis was more successful than exercise therapy, and shockwave therapy combined.

They conclude this time that Ultrasound treatment and exercise are the best treatment option.

Hence, can you see my predicament?

And lastly, let’s conclude with this research:

Comparing shock wave therapy and laser therapy in the elimination of symptoms among patients with myofascial (muscular) pain syndrome in the upper trapezius.

Again 20 patients in each group, and this time the result is:

The conclusion is that shock wave and laser therapy have a similar effect in long term for relieve of pain and eliminating symptoms. But laser provides faster results.

Hence this time, Laser is the winner.

Hence, what do you think I should do?

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