What Is Shockwave Therapy?
Extracorporeal means outside the body. In shockwave therapy, a handheld applicator is placed on the skin over the painful area, with a gel in between, and delivers a series of acoustic pulses into the tissue below. These pulses are thought to increase blood flow, trigger a local healing response and reduce pain signaling in tendons that have not healed on their own.
Shockwave therapy is mainly used for tendinopathy, a long-standing problem in a tendon caused by overuse or wear rather than a sudden tear. Common uses include:
- Tennis elbow (lateral epicondylitis)
- Shoulder tendinopathy, including calcific tendinitis of the rotator cuff
- Plantar fasciitis, a common cause of heel pain
- Achilles tendinopathy
Research supports shockwave therapy for long-lasting tendon problems such as these, and many patients report less pain and better function after a series of sessions.
Performed in our office with a handheld applicator; no needles or anesthesia are needed.
Who Is a Candidate?
You may be a candidate if you have tendon pain that has lasted several months and has not improved enough with rest, stretching, physical therapy, bracing or medication. It can be an option for people who want to try another non-surgical step before considering injections or surgery.
Shockwave therapy is usually avoided if you are pregnant, have a bleeding disorder or take certain blood thinners, have an infection or tumor in the treatment area, or have a pacemaker near the treatment site. It is not used for a fully torn tendon, which needs a different evaluation. Dr. Adelman will confirm the diagnosis, sometimes with diagnostic ultrasound in our office, before recommending treatment.
What to Expect
You sit or lie in a comfortable position. After gel is applied to the skin, the applicator is moved over the painful tendon while pulses are delivered. Treatment sessions are short, often 10 to 20 minutes. You may feel tapping or pressure, and the treated area can feel tender during the session; the intensity can be adjusted.
A typical course involves several sessions, often once a week for three to five weeks, though your plan may differ. You can usually drive yourself home and return to most activities the same day.
Risks and Side Effects
Shockwave therapy is generally well tolerated. Possible side effects include:
- Discomfort during treatment
- Redness, mild swelling or bruising over the treated area
- Temporary soreness for a day or two after a session
- Rarely, skin irritation or numbness
Recovery
There is no downtime for most people. You may be asked to avoid strenuous use of the treated tendon for a couple of days after each session and to avoid anti-inflammatory medicines around treatment. Any improvement usually builds gradually over several weeks to a few months after the course ends.
Shockwave therapy is meant to be one part of a full plan. Our physical and hand therapists work in the same office and share your chart, so stretching and strengthening exercises can continue alongside your sessions.
Physical therapy happens in our office, with therapists who share your chart. Learn about on-site physical therapy.
Insurance and Cost
Coverage for shockwave therapy varies by plan, and many plans do not cover it for these conditions. Please ask our team, who can check your benefits and explain any out-of-pocket cost before you start.
When to Talk to a Specialist
Call our office if tendon pain in your elbow, shoulder, heel or ankle has lasted more than a few months, keeps returning, or limits your work, sport or daily life.
Seek prompt care if you felt a sudden pop followed by weakness, which can signal a torn tendon rather than tendinopathy.
