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What is shockwave therapy?

Shockwave therapy or extracorporeal shockwave therapy (ESWT) is an innovative, cost-effective,

evidence-based treatment for tendon pain (often known as tendinitis or tendinopathy) and other

conditions throughout the body. Extracorporeal means outside of the body.

The main benefits of shockwave are pain relief and restoration of function. Shockwave therapy

has been shown to be an effective treatment modality for a range of common tendon complaints

including plantar fasciitis, Achilles tendinopathy and tennis elbow.

Shockwave therapy is a safe, non-invasive treatment with convincing evidence for its

effectiveness from a large body of research and clinical trials. There are now multiple,

randomised, double-blinded clinical trials that support the use of shockwave therapy

for plantar fasciitis, lateral epicondylitis, and calcific tendinitis of the shoulder.

What is shockwave therapy used for?

Shockwave therapy is an effective treatment modality for a variety of lower and

upper limb conditions. These include:

Bone injuries – Shin splints (MTSS), stress fractures and non-union fractures
Calcific tendinopathy
Tennis elbow (common extensor tendinopathy)
Golfer’s elbow (common flexor tendinopathy)
Greater trochanteric pain syndrome (also referred to as gluteus medius tendinopathy

and/or trochanteric bursitis)
Proximal Hamstring Tendinopathy (also referred to as high hamstring tendinopathy,

or hamstring origin tendinopathy)
Patella tendinopathy
Insertional Achilles tendinopathy
Mid-portion Achilles tendinopathy
Plantar fasciitis

How does shockwave therapy work?

This is sometimes known as its ‘mechanism of action’. Shockwave therapy uses a specialist

device to deliver acoustic energy through the skin to the injured part of the body. The shockwaves

are mechanical and not electric. They are audible, low-energy sound waves, which increase the

blood flow to the injured area.

Shockwave therapy has two main modes of action which will help with persistent tendon pain.

First the shockwaves work to desensitise nerve endings which will often give an immediate

reduction in pain. Secondly, and often most importantly, the shockwaves cause controlled

micro-trauma (microscopic damage) to the tissues which encourages the body to respond

by increasing the blood circulation and metabolism in the affected area. This will activate

and accelerate the body’s own healing response. The shockwaves can also ‘breakdown’

disorganised tissue and calcifications.

Who should have shockwave therapy?

Shockwave therapy is offered to patients who have had their pain for several months and

are not improving with other treatments such as stretches, strengthening exercises, orthotics

and activity modification.
Shockwave therapy is designed for stubborn tendon issues that are not improving. Tendons

compared to muscles, for example, have a relatively poor blood supply so it is not unusual

for them to take several months, even years, for them to improve. Shockwave can speed

up this healing process and get patients back on track.

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