Non-invasive treatment
Extracorporeal shockwave therapy
Shockwave therapy delivers acoustic pressure waves through the skin into a target tissue using a handheld applicator. The mechanism is not fully established; the prevailing explanation is that the mechanical stimulus provokes a local healing response in tissue that has become degenerative and quiescent. It is non-invasive, requires no anaesthetic, and is generally reserved for tendon and fascia problems that have not responded to several months of loading rehabilitation.
What it is used for
Evidence is strongest for a handful of chronic tendon and fascia conditions.
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Plantar fasciitis
One of the better-supported indications, typically for heel pain persisting beyond several months despite stretching, footwear change and load management.
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Tennis and golfer’s elbow
Used for persistent epicondylar tendinopathy where loading rehabilitation has not been sufficient.
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Calcific tendinopathy of the shoulder
Among the indications with the clearest rationale, where calcium deposits within the tendon are the target.
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Other tendinopathies
Achilles, patellar and gluteal tendinopathy are treated in some settings, with evidence that varies by site.
What a course involves
Treatment is delivered in short sessions over several weeks.
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The session
Gel is applied and the applicator held against the target while pulses are delivered, usually for several minutes. Most sessions take under fifteen minutes.
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A typical course
Commonly three to five sessions at weekly intervals, though protocols vary between devices and conditions.
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How it feels
Uncomfortable rather than painful for most people, and intensity is adjusted during the session. No anaesthetic is used, since feedback about the location of the pain helps target treatment.
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Afterwards
Normal activity is usually resumed the same day, with heavy loading of the treated tendon avoided briefly. It is generally combined with a continuing exercise programme.
Evidence, risks and limits
A reasonable option for persistent tendinopathy, but not a first-line treatment and not a substitute for loading.
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What the evidence shows
Meta-analyses support benefit for plantar fasciitis and calcific shoulder tendinopathy, with more variable results elsewhere. Protocol differences between studies make direct comparison difficult.
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Side effects
Transient pain during and after treatment, redness and occasionally bruising. Serious complications are rare.
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When it is not used
Over an area of infection or malignancy, in people with bleeding disorders or on anticoagulation, and over certain anatomical sites. Suitability is assessed before treatment.
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It works alongside exercise
Shockwave is generally studied and used as an addition to a loading programme, not as a replacement for one.
Common questions
Does it hurt?
It is uncomfortable during treatment, and the intensity is adjusted to what can be tolerated. Discomfort typically settles within hours.
How soon does it work?
Improvement is usually gradual over the weeks following a course rather than immediate, and it is normal for symptoms to fluctuate during the course.
How many sessions will I need?
Typically three to five, depending on the condition and the device. Response is assessed as the course proceeds.
Is it the same as ultrasound therapy?
No. Therapeutic ultrasound delivers continuous low-intensity sound waves; shockwave delivers discrete high-energy pulses. The evidence base for the two is different.
General reference information, and not advice about your own case. It may not reflect the most recent guidance or what is offered on a given day — call (201) 408-5151 to check.
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Dr. Yoo Rehab Clinic welcomes new patients from across Northern New Jersey and New York City, including Englewood, Teaneck, Fort Lee, Palisades Park and Ridgefield. Call today to learn more about insurance, scheduling, and how we can help.
