BACKGROUND: Extracorporeal Shockwave Therapy (ESWT) was first introduced into clinical practice in 1982 and has proved to be a beneficial adjuvant in the non-invasive treatment of numerous orthopaedic pathologies. However, clinical evidence reporting the use of ESWT in treating musculoskeletal disorders of the foot and ankle remain limited and a general consensus on its efficacy has not been achieved. Therefore, we reviewed the available literature and analysed any reported evidence in order to determine the benefits of ESWT in this cohort. METHODS: PubMed, EMBASE and Cochrane Library databases were systematically reviewed for any clinical studies that reported the treatment of foot and ankle disorders with ESWT. RESULTS: A total of 24 clinical studies, including 12 randomised control trials and 12 case series, were identified and included into this study. Analysis of the reported evidence indicate that ESWT can be beneficial in the symptomatic management of plantar fasciitis, calcaneal spur, Achilles tendinopathy and Morton's neuroma. However, differences in ESWT protocols used limit the generalizability of these findings and prevented an optimum treatment protocol from being determined. CONCLUSIONS: Evidence from the articles analysed in this review suggest a beneficial healing effect of ESWT in treating musculoskeletal disorders affecting the foot and ankle, with minimal side effects being reported. Thus, ESWT can be used safely in combination with other treatment modalities in order to achieve the best patient outcomes. Future studies should attempt to optimize the treatment protocols of ESWT to confirm these findings.

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