Is shockwave 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. Steroids may relieve pain quickly, but 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 get you out of pain fast.
Conditions treated
Radial shockwave is most often used for musculoskeletal problems close to the surface, including:
- Plantar fasciitis / plantar fasciopathy (heel pain)
- Achilles tendinopathy (midportion and insertional)
- Lateral epicondylitis (tennis elbow), especially stubborn cases
- Rotator cuff tendinopathy and calcific tendinitis of the shoulder
- Patellar tendinopathy (jumper's knee) and other chronic tendinopathies
- Myofascial trigger points and certain soft-tissue pain syndromes, often alongside other rehab
What to expect
Typical course
6–12 sessions spaced 2–3 days apart. Protocols vary by condition.
Session length
Each treatment takes only about 5 minutes.
What to wear
The applicator needs skin contact over the painful area, so shorts, a tank top or a t-shirt may be best.
Combined care
Many patients pair shockwave with adjustments, exercise and stretching for the best results.
Common side effects: some discomfort or aching during and after treatment, minor bruising, local swelling or numbness. These are typically short-lived.
How it works
Radial shockwave therapy (rSWT), also called radial pressure wave therapy or radial extracorporeal shock wave therapy (rESWT), delivers high-energy pressure waves into soft tissue near the surface. It's used by physical therapists, sports medicine clinics, orthopedists and chiropractors for chronic tendon and fascia problems that haven't improved with rest, stretching or standard conservative care. (Physiopedia)
The pressure wave is thought to:
- Break up small calcific deposits and scar tissue
- Increase local blood flow and metabolism
- Trigger a controlled healing response and tissue remodeling
- Reduce pain signals from the treated area
"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."
Lopes Simplicio et al., J Clin Orthop Trauma, May 2020
Main benefits
- Non-invasive: no needles or incisions, done right here in the office.
- Less pain, better function: studies and systematic reviews report meaningful pain relief and functional gains for many tendinopathies and plantar fasciitis. (PMC)
- Longer-lasting improvement: some trials show benefits persist at mid-term follow-up. (PubMed)
- Fewer risks than steroids: a local, drug-free treatment with no systemic steroid effects.
- Quick sessions: about 5 minutes each, and easy to combine with exercise and other rehab.
Common questions
I tried massage and it didn't work. Will shockwave be different?
It may be. Studies comparing shockwave to manual therapies such as deep friction massage often report greater reductions in pain and disability with shockwave for certain tendon conditions. Massage is excellent for loosening soft tissue, but it doesn't mechanically disrupt calcium deposits or directly stimulate the cellular healing pathways that shockwave can. Shockwave is also device-based, so results depend less on one therapist's technique. (Nature)
Can't I just get a steroid shot?
Steroid injections often give faster short-term relief (weeks), but multiple studies show shockwave can lead to better pain and function in the mid-term (months) for conditions such as plantar fasciitis. Repeated steroid injections can also weaken tendons or fascia and carry systemic hormone effects, while shockwave is applied externally with no drug and no needle. (PubMed)
Does it hurt?
Some discomfort during treatment is common, and the area may ache afterward. This is usually brief, and we adjust the intensity to what you can tolerate.
How soon will I feel better?
Many people notice changes over the course of treatment. Because shockwave works by stimulating healing, improvement often continues for weeks after the last session.
The research
For anyone who wants to dig into the evidence:
| Study / review | Key findings |
|---|---|
| Shockwave therapy on patellar tendinopathy, Achilles tendinopathy and plantar fasciitis: systematic review and meta-analysis (2023) | Reviewed 63 studies. For plantar fasciitis, shockwave had a large effect on pain and function (short-, mid- and long-term). Results for patellar and Achilles tendinopathy were more mixed. |
| ESWT in plantar fasciopathy: systematic review with meta-analysis and meta-regression (2023) | Randomized trials showed ESWT is effective and tolerable, with significant reduction in pain for both focal and radial ESWT. |
| ESWT for foot and ankle disorders: systematic review and meta-analysis (2021) | For plantar fasciitis, ESWT significantly improved pain scores versus placebo or conservative care (about 3.1 points on a 10-point scale) and was considered safe. |
| ESWT for chronic plantar fasciitis: systematic review of randomized controlled trials (2021) | Across 11 trials (658 patients), moderate evidence that ESWT improved pain and foot function. |
| Effectiveness and safety of shockwave therapy in tendinopathies (2018) | Shockwave significantly reduced pain and improved function and quality of life across elbow, Achilles, plantar and rotator cuff tendinopathies, with a good safety profile. |
| Radial ESWT for chronic recalcitrant plantar fasciitis: randomized placebo-controlled multicenter study (2008) | In 245 patients, radial ESWT significantly improved pain and function versus placebo, with effects lasting at 12 months. |
Medical disclaimer: this page is informational only and is not medical advice. If you're considering radial shockwave therapy, talk with your physician, chiropractor, orthopedist or physical therapist about whether it's right for your condition.