Shockwave therapy is a non-surgical treatment method primarily used in orthopedics, sports medicine, and trauma care. High-energy extracorporeal shock waves are directed precisely at the affected soft tissue, where they stimulate the body’s healing process, relieve pain, and treat musculoskeletal conditions such as stress fractures, tennis elbow, or plantar fasciitis.
These therapeutic pressure waves, generated outside the body (extracorporeal), are applied through a shockwave device. The procedure is therefore also referred to as Extracorporeal Shockwave Therapy (ESWT), a proven shockwave treatment in physical therapy and rehabilitation that helps reduce pain and promote healing.
Shock wave therapy can significantly reduce pain. © freshidea /
Physicians distinguish between radial and focused shockwaves depending on their propagation. Radial shockwave therapy acts across the surface of a pain zone and is often applied in physical therapy and rehabilitation for musculoskeletal conditions. In contrast, focused shockwave therapy delivers enhanced power, penetrating more deeply into the body. These waves are meticulously aimed at a specific point for optimal therapeutic results.
When shock waves are directed at the diseased area of the body, they trigger not only mechanical stimuli but also biochemical reactions.
These manifest in various processes:
- Improved blood circulation and stimulation of metabolism
- The body releases active proteins such as growth factors for regeneration and messenger substances for metabolism (enzymes)
- Stimulation of bone healing
- Formation of new tissue
- Promotion of wound healing
Extracorporeal shock wave therapy (ESWT) stimulates the body’s natural self‑healing processes, a valuable effect in orthopedic conditions, pain relief, and the management of musculoskeletal disorders. The effects of shockwaves are widely applied in sports injuries, rehabilitation, and the treatment of chronic problems such as plantar fasciitis and tennis elbow, showing the broad effectiveness of extracorporeal shock wave treatment in modern physical medicine.
Originally introduced for lithotripsy in the treatment of kidney stones, shockwave therapy now has broad clinical applications. Today, extracorporeal shockwave therapy in musculoskeletal medicine is recognized as a versatile option in urology, orthopedics, surgery, and dermatology, often used as a conservative treatment for chronic pain and delayed healing.
Doctors prescribe shockwave treatment for management of several orthopedic conditions, including:
Before undergoing shockwave therapy, patients often want to understand more about the procedure.
The physician begins by identifying the painful area and marking it. In some cases, an additional X-ray or ultrasound is used to pinpoint the exact site of the condition. Most patients do not require anesthesia, though a local anesthetic may occasionally be applied to the affected area.
Shock wave treatment. © Dan Race / Fotolia
The shockwave device produces pressure waves and channels their energy into a handpiece (transducer).
The physician then places the transducer on the marked area, delivering the sound waves into the tissue under high pressure.
Patients may find the first impulses somewhat painful, but the discomfort usually eases as the session continues. The physician ensures that the pain remains tolerable throughout.
A typical course of shockwave therapy lasts 5 to 15 minutes per session. Depending on the condition, treatment generally involves between one and five sessions.
Follow-up treatment is seldom required. If pain occurs after the procedure, you may use over-the-counter medication and apply cold packs to the treated area.
It is recommended to rest the affected body part for a few days. In most cases, however, you remain fully able to work. Your physician will advise whether further follow-up care is needed and what it should include.
Shockwave therapy is a non-invasive, low-complication treatment, but in rare cases the following side effects may occur:
- Temporary redness or swelling of the skin
- Short-term increase in pain
- Bruising (hematomas)
- Minor bleeding of the periosteum (bone covering)
- A slightly increased risk of additional injuries such as tendon rupture
The prognosis and effectiveness of shockwave therapy depend on the specific condition being treated.
Around 75 percent of patients with calcific shoulder tendinitis or tennis/golfer’s elbow experience complete relief or significant improvement after treatment. For patients with heel spurs, the success rate is also high at about 65 percent. In general, shockwave therapy reduces pain across a wide range of conditions, though some patients do not respond to the treatment.
Although shockwave treatment is a gentle alternative to surgery, it is not suitable for everyone.
Doctors exclude shock wave therapy in the following cases:
- Children, adolescents, and pregnant women
- Patients with blood clotting disorders
- Patients with infections or severe inflammation of the bones or skin
- Patients with malignant tumors
- Patients with pacemakers
Your treating physician will advise you and create an individualized treatment plan.
Private health insurance usually covers the costs in full if the physician provides medical justification for the therapy. In contrast, statutory health insurance generally does not cover shockwave therapy. Only in exceptional cases may partial reimbursement be granted. It is best to check with your insurance provider before treatment. A single shock wave session costs between 60 and 100 euros.
