What Shockwave Therapy Is
Extracorporeal shockwave therapy, or ESWT, uses a handheld applicator to send high-energy acoustic pulses through the skin into injured tissue. There are no needles, no medication and no incisions. It is used mainly for stubborn tendon and soft-tissue problems that haven't healed with rest, stretching, or other care.
What the Research Says
Shockwave has been studied most for heel pain. A systematic review and meta-analysis pooled 11 randomized trials with 1,081 participants and found that shockwave therapy for plantar fasciitis reduced pain by roughly three points on a ten-point scale, with both focused and radial devices. The authors concluded that it seems to be an effective and well-tolerated treatment.
It has also been studied for other tendon problems, including shockwave for Achilles tendinopathy. As with most treatments, results differ from person to person and from one condition to the next, and we'll tell you honestly whether your problem is one it suits.
Conditions We Use It For
- Plantar fasciitis and heel pain — Pain under the heel that is worst with the first steps in the morning.
- Achilles tendinopathy — A sore, thickened Achilles tendon, common in runners.
- Tennis elbow and golfer's elbow — Tendon pain on the outside or inside of the elbow.
- Shoulder tendinopathy — Long-standing rotator cuff tendon pain, including calcific tendinopathy. Read more about shoulder pain.
- Jumper's knee — Pain in the tendon just below the kneecap. Read more about knee pain.
- Outer hip pain — Irritated tendons on the outside of the hip. Read more about hip pain.
What a Session Is Like
We find the sore area, apply gel, and move the applicator over it while it delivers a set number of pulses. It can be uncomfortable over the tender spot, and we adjust the intensity to what you can tolerate. Sessions are short, and you can walk out and get on with your day. Some soreness afterward is common and usually settles quickly.
Shockwave is typically done as a short series of sessions. Dr. Nasser will recommend a number after examining you.
How It Fits Into Your Plan
Shockwave works best as part of a rehabilitation plan. Tendons recover by being loaded progressively, so we pair it with specific strengthening exercises and with treatment of whatever overloaded the tendon to begin with, whether that's a stiff ankle, weak hips, or your training schedule. That is the same approach we take to sports injuries and to physical rehabilitation in general.
Who Shouldn't Have It
Shockwave isn't suitable for everyone. We check first for anything that rules it out, such as pregnancy, a bleeding disorder or blood-thinning medication, an infection or tumor in the treatment area, or a recent steroid injection at the site. If it isn't appropriate for you, we'll recommend something else.
Cost
Shockwave therapy is a paid treatment. It is not included in the free consultation. Ask us for the current price per session. If cost is a concern, see our patient assistance options.
Your First Visit: What to Expect
Your initial appointment is a comprehensive 3-step process designed to move you from pain to performance. It is a paid visit, separate from the free consultation.
Medical history review, orthopedic and neurological testing, and biomechanical analysis to understand not just where it hurts, but why it hurts.
We sit down with you to explain what is causing your pain, our recommended recovery plan, and how long we expect your recovery to take.
When it is possible and safe to do so, we begin your first phase of therapy during your first visit: gentle spinal adjustments, manual soft-tissue therapy, or initial corrective exercises.