In the world of modern physical medicine, shockwave therapy—also known as extracorporeal shock wave therapy (ESWT)—has emerged as a powerful, non-invasive treatment option for various musculoskeletal conditions. Essentially, it’s a procedure that delivers high-energy acoustic waves directly to the painful or injured area of the body, using a specialized device that generates these waves outside the body (hence “extracorporeal”). This therapy is commonly used to address issues like tendinitis, plantar fasciitis, myofascial pain syndrome, and even some neurological diagnoses, offering an alternative to surgery or long-term medication for those dealing with persistent pain. Unlike traditional methods, it doesn’t involve incisions or injections, making it appealing for patients seeking quicker recovery times.
Relief
The theory behind shockwave therapy revolves around its ability to trigger the body’s natural healing processes at a cellular level. These acoustic waves create micro-trauma in the targeted tissues, which stimulates biological responses such as increased blood flow (vascularization), enhanced protein synthesis for tissue repair, and the release of growth factors that promote regeneration. Additionally, it influences pain perception through mechanisms like the gate-control theory, where the overstimulation of nociceptors (pain receptors) blocks pain signals from reaching the brain, while also reducing inflammation and breaking down calcified deposits in tendons or ligaments. In essence, the therapy mimics a controlled injury to kickstart repair, drawing on the body’s innate regenerative capabilities to heal chronic issues that haven’t responded to conservative treatments.
How does it work?
When it comes to how shockwave therapy actually works in practice, the process is straightforward and typically performed in an outpatient setting. A clinician applies a gel to the skin over the affected area to facilitate wave transmission, then uses a handheld applicator to deliver pulses of energy—often in sessions lasting 10-20 minutes, with 1,000 to 2,000 impulses per treatment. There are two main types: focused shockwave therapy, which penetrates deeper for conditions like bone healing, and radial shockwave therapy, which spreads waves more superficially for soft tissue issues. Patients might feel a tapping or pulsing sensation during the session, sometimes with mild discomfort. Over multiple sessions (usually 3-5 spaced a week apart), the waves induce interstitial and extracellular changes, leading to improved tissue health and reduced pain.
Results
The results of shockwave therapy have been promising, backed by numerous studies showing its effectiveness in pain management and functional recovery. For instance, research on tendinopathies has demonstrated significant reductions in pain intensity and improvements in daily activities after just a few sessions, with success rates often exceeding 70-80% for conditions like rotator cuff tendinitis or Achilles tendinopathy. In myofascial pain syndrome, patients report decreased pain scores and better mobility, with effects lasting months post-treatment. Overall, it’s considered safe with minimal side effects like temporary redness or swelling, and it’s particularly effective for chronic cases where other therapies have failed, leading to faster healing and a return to normal activities.
Integrative Approach.
While shockwave therapy can deliver impressive standalone results, it truly shines when integrated into a complete physical medicine program. Combining it with elements like targeted exercises, manual therapy, ergonomic adjustments, and lifestyle modifications addresses not just the symptoms but the root causes of pain, such as poor biomechanics or muscle imbalances. This holistic approach enhances long-term outcomes, prevents recurrence, and maximizes the therapy’s regenerative benefits, ensuring patients achieve sustainable relief and improved quality of life.
Schedule a consultation with our office to see if you could benefit from shockwave therapy!
Sources:
- Wang, C. J. (2012). Extracorporeal shockwave therapy in musculoskeletal disorders. Journal of Orthopaedic Surgery and Research, 7, 11. https://doi.org/10.1186/1749-799X-7-11
- Jeon, J. H., et al. (2018). The effect of extracorporeal shock wave therapy on myofascial pain syndrome. Annals of Rehabilitation Medicine, 42(2), 294–303. https://doi.org/10.5535/arm.2018.42.2.294
- Moya, D., et al. (2018). The role of extracorporeal shockwave treatment in musculoskeletal disorders. The Journal of Bone and Joint Surgery, 100(3), 251–263. https://doi.org/10.2106/JBJS.17.00661
- Ramon, S., et al. (2020). Shockwave therapy for the treatment of chronic pain: A review. Pain Management, 10(2), 113–122. https://doi.org/10.2217/pmt-2019-0057
- Schmitz, C., et al. (2015). Efficacy and safety of extracorporeal shock wave therapy for orthopedic conditions: A systematic review. American Journal of Sports Medicine, 43(12), 3097–3107. https://doi.org/10.1177/0363546515581462
- Speed, C. A. (2014). Extracorporeal shock-wave therapy in the management of chronic soft-tissue conditions. The Journal of Bone and Joint Surgery, 96-B(4), 433–439. https://doi.org/10.1302/0301-620X.96B4.32376
- Rompe, J. D., & Maffulli, N. (2007). Repetitive shock wave therapy for lateral elbow tendinopathy (tennis elbow): A systematic and qualitative analysis. British Medical Bulletin, 83(1), 355–378. https://doi.org/10.1093/bmb/ldm019
- Louwerens, J. K., et al. (2020). Extracorporeal shock wave therapy for plantar fasciitis: A randomized controlled trial. Foot & Ankle International, 41(5), 533–539. https://doi.org/10.1177/1071100720903708
- Notarnicola, A., & Moretti, B. (2012). The biological effects of extracorporeal shock wave therapy (ESWT) on tendon tissue. Muscles, Ligaments and Tendons Journal, 2(1), 33–37. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3666498/
