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Radial Shockwave Therapy

A non-invasive treatment that can reduce pain, stimulate healing, and improve function for many chronic tendon and fascial conditions.

What It Is and Whether It May Be Right for You

Radial shockwave therapy is a non-invasive treatment that can reduce pain and improve function for many chronic tendon and fascial conditions. Compared with massage, it more directly stimulates healing and can better address calcifications and tendinopathy. Compared with steroid injections, it avoids drug-related risks and, while steroids may relieve pain quickly, shockwave often provides more durable mid-term improvement for some conditions.

If you have foot, ankle, knee, shoulder, or elbow pain, shockwave may be a great option to help get you out of pain quickly.

Let us help you feel better, with no needles and no drugs. Call 817-805-2646 to schedule your free shockwave consultation today.

If you really want to nerd out on how shockwave stimulates healing in your body, backed with research, keep reading.

Radial shockwave therapy (rSWT) — also called radial pressure wave therapy or radial extracorporeal shock wave therapy (rESWT) — is a non-invasive treatment that delivers high-energy pressure waves into superficial soft tissue to reduce pain and stimulate healing. It's most commonly used by physical therapists, sports medicine clinics, orthopedists, and chiropractors for chronic tendon and fascial problems that haven't improved with rest, stretching, or standard conservative care. (Physiopedia+1)

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How It Works

Radial shockwave devices generate a pressure wave that travels outward from the applicator. This pressure wave is thought to:

  • Break up small calcific deposits and scar tissue
  • Increase local blood flow and metabolism
  • Trigger a controlled inflammatory/healing response and tissue remodeling
  • Reduce pain signals from the treated area (Blue Cross Blue Shield of Rhode Island)

"Shockwaves can generate interstitial and extracellular responses, producing many beneficial effects such as pain relief, vascularization, protein biosynthesis, cell proliferation, neuro and chondroprotection, and destruction of calcium deposits in musculoskeletal structures. The combination of these effects can lead to tissue regeneration and significant alleviation of pain, improving functional outcomes in injured tissue."

Lopes Simplicio et al., J Clin Orthop Trauma, May 2020

Main Benefits of Radial Shockwave Therapy

  • Non-invasive: No needles or incisions; usually performed in an outpatient clinic. (Physiopedia)
  • Pain reduction and improved function: Studies and systematic reviews report meaningful pain relief and functional gains for a variety of tendinopathies and plantar fasciitis. (PMC+1)
  • Potential longer-term improvement: Some trials show that shockwave's benefits persist at mid-term follow-up and can be superior to short-term treatments. (PubMed+1)
  • Fewer systemic risks than steroids: because it's a local, non-drug treatment, it avoids systemic steroid effects and some steroid-related local complications. (PubMed)
  • Quick sessions and easy to combine with rehab: sessions are typically brief (10-20 minutes) and can be combined with exercise and other rehabilitation approaches. (ScienceDirect)

Common Questions

"I have tried a massage and it didn't work? Will I have different results with Shockwave?"

Advantages over traditional massage therapy
  • Stronger evidence for structural tendinopathy changes: Recent studies comparing ESWT to manual therapies (for example, deep friction massage or ultrasound plus massage) often report greater reductions in pain and disability with shockwave therapy. For certain tendon conditions, shockwave can produce faster and larger improvements. (Nature+1)
  • Targets deeper pathology and calcifications: Massage is excellent for soft-tissue mobilization and symptom relief, but it does not mechanically disrupt calcific deposits or directly stimulate the cellular healing pathways that shockwaves can. (Blue Cross Blue Shield of Rhode Island)
  • Less dependence on therapist skill: Outcomes from massage can vary substantially with practitioner technique; shockwave delivery is device-based and more standardized. (Physiopedia)

"Can't I just get a steroid shot?"

Advantages over steroid injections
  • Better mid- to long-term outcomes in some conditions: While steroid injections often produce faster short-term pain relief (weeks), multiple studies show shockwave therapy can lead to better pain and functional outcomes in the mid-term (months) for conditions such as plantar fasciitis. That makes shockwave an attractive option when the goal is durable improvement. (jfas.org+1)
  • Lower risk of local tissue weakening or systemic effects: Repeated steroid injections can weaken tendons or fascia and carry systemic hormone effects; shockwave avoids those drug-related risks. (PubMed)
  • No need for image-guided needle placement (in many cases): Shockwave is applied externally; injections require accurate placement and carry small risks of infection, bleeding, or post-injection flare. (Physiopedia)

Common ailments treated with radial shockwave therapy

Radial shockwave is most often used for superficial musculoskeletal complaints, including:

  • Plantar fasciitis / plantar fasciopathy (heel pain) (PubMed+1)
  • Achilles tendinopathy (midportion and insertional) (Cureus)
  • Lateral epicondylitis (tennis elbow) - especially refractory cases (SourceDirect+1)
  • Rotator cuff tendinopathy / calcific tendinitis of the shoulder (especially calcific deposits) (Blue Cross Blue Shield of Rhode Island)
  • Patellar tendinopathy (jumper's knee) and other chronic tendinopathies. (PMC)
  • Myofascial trigger points and certain soft-tissue pain syndromes - often as an adjunct to other rehab (Physiopedia)

What to Expect During Treatment

  • Typical course: 6-12 sessions spaced 2–3 days apart. (protocols vary by condition).
  • Clothing: The applicator must be in contact with the skin over the complaint area, so you may need to wear shorts, a tank top, or a t-shirt for treatment.
  • Session length: Each session is brief, often 5 to 10 minutes. Some discomfort or aching during and after treatment is common but usually transient.
  • Combined care: Many patients will be treated with shockwave in addition to chiropractic adjustments, exercise, stretching, or physical therapy for best results. (ScienceDirect+1)
  • Common side effects: Temporary pain during treatment, minor bruising, local swelling, or numbness - typically short-lived (PMC)

More Nerd Stuff - Research

Study / Review Key Findings / Relevance
The effectiveness of shockwave therapy on patellar tendinopathy, Achilles tendinopathy, and plantar fasciitis: a systematic review and meta-analysis (2023)
 This meta-analysis reviewed 63 studies and concluded that for plantar fasciitis (PF), shockwave therapy had a large effect on reducing pain and improving function (short-, mid-, and long-term). For patellar and Achilles tendinopathy, results were more mixed ("negligible to small" effect). (Frontiers)
Efficacy and tolerability of extracorporeal shock wave therapy in patients with plantar fasciopathy: a systematic review with meta-analysis and meta‑regression (2023)
 This meta-analysis of randomized controlled trials concluded ESWT is effective and tolerable for plantar fasciopathy — showing statistically significant reduction in pain intensity (both focal- and radial-ESWT). (PubMed)
Extracorporeal shock wave therapy for foot and ankle disorders: A systematic review and meta-analysis (2021)
 This review encompassed plantar fasciitis, calcaneal spur, Achilles tendinopathy, and other foot/ankle disorders. For plantar fasciitis, ESWT significantly improved pain scores vs. placebo/conservative treatment (mean difference ≈ –3.10 VAS points). It suggested ESWT as a safe option. (PubMed)
Extracorporeal shock wave therapy on pain and foot functions in subjects with chronic plantar fasciitis: systematic review of randomized controlled trials (2021)
 Based on 11 RCTs (658 patients), this review found "moderate" evidence that ESWT improved pain and foot function in chronic plantar fasciitis. (PubMed)
Effectiveness and Safety of Shockwave Therapy in Tendinopathies (2018)
 This review reported that shockwave therapy significantly reduces pain and improves function and quality of life across a variety of tendinopathies (elbow, Achilles, plantar, rotator cuff), with good safety profile. (PubMed)
Radial extracorporeal shock wave therapy is safe and effective in the treatment of chronic recalcitrant plantar fasciitis: results of a confirmatory randomized placebo‑controlled multicenter study (2008)
 A randomized, placebo-controlled trial with 245 patients showing radial ESWT significantly improved pain and function vs placebo — with effects persisting at 12 months. (PubMed)