ESWT Achilles Tendonitis Treatment 

Quick answer: Treatment for eswt achilles tendonitis treatment follows a stepwise approach: 1) conservative care first (rest, ice, supportive footwear, OTC anti-inflammatories), 2) physical therapy and targeted exercises, 3) in-office treatments (injections, custom orthotics) if conservative fails at 4-6 weeks, 4) surgery for refractory cases. Most patients resolve at step 1 or 2. Call (810) 206-1402.

✅ Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatrist · Last updated April 6, 2026

ESWT For Achilles Tendonitis Treatment

ESWT For Achilles Tendonitis Treatment. This is an extremely proven and effective therapy. This is available at our clinics as a part of your treatment.       ESWT for achilles tendonitis treatment.

What is ESWT for the Achilles tendon?

• ExtraCorporeal Shockwave Therapy is a noninvasive method that uses pressure waves to treat various musculoskeletal conditions. High-energy acoustic waves (shock waves) deliver a mechanical force to the body’s tissues.

ESWT is a safe, effective and proven non-surgical treatment.

When should I avoid ESWT for my Achilles tendon?

• Complications are infrequent with shock wave therapy.
• People who have poor sensation (neuropathy) or hypersensitivity in the target area should not have this procedure.
• Open sores should also be avoided. Shock wave therapy is not used in patients with heart conditions or seizures.
• It should not be used during pregnancy.
• This should be discussed with your physician before undergoing the procedure.

 

What is Achilles Tendonitis?

• Achilles tendonitis is a painful and often debilitating inflammation or injury of the Achilles tendon.
• This large tendon is an extension of the two calf muscles; it runs down the back of the lower leg and attaches to the heel bone (calcaneus).
• The Achilles tendon connects the strong leg muscles to the foot and gives you the ability to rise up on your toes, which allows you to walk.
• Unfortunately, Achilles tendonitis can make walking almost impossible.

 

2 Phases of Achilles Tendonitis:

There are two phases of the condition.

1)Acute Achilles Tendonitis:

• Achilles Tendonitis is inflammation.  Inflammation alone can be treated with numerous conservative treatments.  Anything that addresses rest and inflammation can be helpful.  The doctor may use a steroid injection, strapping, taping, orthotics, or lasers in this phase.  If the condition has moved on to phase 2, the tissue is damaged (microtearing), and needs to be repaired.

2)Chronic Achilles Tendonitis:

• For Phase 2 or chronic achilles tendonitis, high energy ESWT is FDA approved and has been shown to prevent surgery. ESWT shockwave therapy is a device proven to create this repair without surgery.

Benefits of ESWT Achilles Tendonitis Treatment:

 

• The effects of ESWT are best documented in areas of changes in tissue density, such as those where a tendon attaches to a bone (enthesiopathies) and where a bone attaches to a ligament (desmopathies).
• For this reason, it is very effective for painful connective tissue in the foot and heels.
• Additionally, ESWT gives new hope by relieving pain, eliminating the risk factors associated with surgery and allowing people to resume their normal lives.

Conservative Foot Treatment Options in Michigan: From Orthotics to EPAT

Michigan patients with foot and ankle conditions benefit from access to the full range of conservative treatment options at Balance Foot & Ankle. Custom orthotics fabricated from a 3D scan of the patient’s foot provide structural correction for flatfoot, high arch, and biomechanical overload conditions that OTC insoles cannot adequately address. EPAT (extracorporeal pulse activation therapy) provides a non-surgical treatment option for plantar fasciitis, Achilles tendinopathy, and other tendon conditions that resist initial conservative care — clinical evidence shows 70-80% cure rates for chronic plantar fasciitis. Ultrasound-guided injection therapy allows precise corticosteroid, PRP, or local anesthetic delivery to specific anatomical targets including the plantar fascia insertion, retrocalcaneal bursa, Morton’s neuroma interspace, and ankle joint. Physical therapy coordination with specific home exercise prescription addresses strength and flexibility deficits that perpetuate foot and ankle conditions. Michigan patients who want conservative treatment options before considering surgery can call Balance Foot & Ankle at (810) 206-1402 for an evaluation at our Howell or Bloomfield Hills office.

Expert Podiatric Care for Michigan Patients: Balance Foot & Ankle

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Related Treatment Guides

• Plantar Fasciitis & Heel Pain Treatment
• Custom 3D Orthotics
• Foot & Ankle Arthritis Treatment

Michigan patients with any foot or ankle condition — whether a first-time acute problem or a chronic issue that has not responded to self-care — can access expert podiatric evaluation and treatment at Balance Foot & Ankle. Our fellowship-trained podiatric surgeons provide thorough diagnostic evaluation using weight-bearing digital X-rays and musculoskeletal ultrasound, followed by targeted conservative or surgical treatment appropriate to the specific diagnosis. We treat the full spectrum of podiatric conditions: plantar fasciitis, Achilles tendinopathy and rupture, Haglund’s deformity, bunions, hammertoes, neuromas, peripheral neuropathy, diabetic foot complications, toenail fungus, ankle instability, stress fractures, and more. Balance Foot & Ankle accepts Blue Cross Blue Shield of Michigan, Aetna, UnitedHealthcare, Cigna, Medicare, and most Medicare Advantage plans. Same-week new patient appointments are available at our Howell (4330 E Grand River, serving Livingston County) and Bloomfield Hills (43494 Woodward Ave #208, serving Oakland County) offices. Call (810) 206-1402 to schedule.

Medical References & Sources

• American Orthopaedic Foot & Ankle Society — Achilles Tendinopathy
• PubMed Research — Achilles Tendinopathy Treatment

References

1. Maffulli N, et al. Extracorporeal shock wave therapy for tendinopathies. Bone Joint J. 2020;102-B(2):263.
2. Rompe JD, et al. Shock wave therapy for chronic Achilles tendinopathy. Am J Sports Med. 2009;37(3):463-470.
3. Saxena A, et al. Extracorporeal pulsed-activated therapy for chronic Achilles tendon disorders. J Foot Ankle Surg. 2011;50(4):416-419.

In-Office Treatment at Balance Foot & Ankle

If home treatment isn’t providing relief for your Achilles tendon conditions, our podiatry team at Balance Foot & Ankle can help with same-day evaluations and advanced in-office care.

Frequently Asked Questions

How long does treatment take to work?

Most patients see improvement in 4-8 weeks with consistent conservative care. Persistent symptoms after 8 weeks need imaging and escalation.

When is surgery needed?

Surgery is reserved for cases that fail 3-6 months of conservative care, structural deformities, or fractures requiring stabilization.

Is this covered by insurance?

Most diagnostic visits and conservative treatments are covered by Medicare and major insurers. Custom orthotics often require diabetic or post-surgical justification.