Extracorporeal shockwave therapy (ESWT) uses pulses of acoustic energy, delivered through the skin, to stimulate healing in stubborn tendon and soft-tissue problems.
How it works
The pulses create controlled micro-trauma in the treated tissue. That sounds counterintuitive, but it’s the point: the small disruption triggers a fresh healing response — new blood vessel growth, increased cell turnover — in tissue that’s become stuck in a chronic, degenerative state rather than actually healing. There are two main types: focused shockwaves, aimed precisely at a single deeper point, and radial shockwaves, which spread energy over a wider, more superficial area. Which one is used depends on the target tissue.
What it’s used for
- Plantar fasciitis — one of the best-supported uses
- Calcific tendinitis of the shoulder
- Chronic tendinopathies: Achilles, patellar (jumper’s knee), and tennis elbow
It’s generally considered for chronic cases — typically after 3–6 months of conservative treatment like structured exercise (see our Achilles guide) hasn’t fully resolved the problem, rather than as a first-line treatment.
What to expect
Sessions are done in clinic, take about 10–20 minutes, and don’t require anesthesia — though the pulses can be uncomfortable in the moment. Most protocols involve 3–5 sessions spaced about a week apart. It’s normal to feel some soreness for a day or two afterward, similar to a hard workout. Improvement tends to build gradually over several weeks rather than appearing immediately.
This page is educational and general in nature and does not replace an individualized evaluation — see our medical disclaimer.