Treatment
Shockwave therapy: how it works and what it treats
A clinically reviewed guide to extracorporeal shockwave therapy (ESWT) — how it works, what it helps, and what to expect.
Quick answer
Shockwave therapy (ESWT) uses acoustic pressure waves to stimulate healing in certain tendon and soft-tissue conditions. It is non-invasive and delivered over several sessions. Evidence is strongest for plantar fasciitis and calcific shoulder tendinopathy, and it is usually used alongside an exercise programme.
Key facts
- Shockwave is non-invasive and delivered over several short sessions.
- Evidence is strongest for plantar fasciitis and calcific shoulder tendinopathy.
- It works best combined with an exercise programme, not on its own.
What is shockwave therapy?
Shockwave therapy is a non-invasive treatment that delivers acoustic (sound) pressure waves to injured tissue through the skin.
Also called extracorporeal shockwave therapy (ESWT), it is applied with a handpiece over several sessions. It is most often used for stubborn tendon and soft-tissue conditions that have not settled with exercise alone.
How does shockwave therapy work?
The pressure waves are thought to stimulate the body's healing response in the treated tissue, encouraging repair and reducing pain.
Proposed mechanisms include stimulating local blood flow and cellular repair activity and modulating pain. It does not replace the loading a tendon needs, which is why it is paired with exercise.
What conditions does shockwave therapy treat?
Shockwave has the strongest evidence for plantar fasciitis and calcific shoulder tendinopathy, with more mixed evidence for other tendon problems.
What should I expect during shockwave therapy?
Sessions are short (around 10–20 minutes), usually over several weeks, and may cause temporary discomfort or redness.
Shockwave therapy is not suitable for everyone. We do not use it — or we proceed only after medical clearance — in situations including pregnancy (particularly near the abdomen or pelvis), an active cancer or tumour at or near the treatment area, bleeding or blood-clotting disorders or use of blood-thinning (anticoagulant) medication, a pacemaker or other implanted electronic device near the treatment site, open growth plates in children and adolescents who are still growing, and active infection or an open wound at the site. A clinical assessment and review of your medical history determine whether it is appropriate for your condition.
- A typical course is several sessions spaced about a week apart
- Treatment can feel uncomfortable but is generally well tolerated
- Mild, temporary redness or soreness afterwards is common
- It is combined with an exercise programme for best results
Get a clear plan for your extracorporeal shockwave therapy
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This page is for general information and is not a substitute for professional medical advice, diagnosis or treatment. Always consult a qualified clinician about your individual condition.
Sources
- Bones, Joints and Muscles — MedlinePlus, US National Library of Medicine
- Muscle and Bone Diseases — NIH National Institute of Arthritis and Musculoskeletal and Skin Diseases
- Joint Disorders — MedlinePlus, US National Library of Medicine
- Orthopedic services — MedlinePlus Medical Encyclopedia
- Aging changes in the bones, muscles and joints — MedlinePlus Medical Encyclopedia