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Extracorporeal Shockwave Therapy

Extracorporeal shockwave treatment, commonly known as ESWT, is a non-invasive medical procedure that uses shockwaves to treat a variety of musculoskeletal conditions. This therapy has been used in Europe for more than two decades and is gaining popularity in the United States.

What is Extracorporeal Shockwave Treatment?

ESWT involves the use of a machine that sends acoustic or sound waves into your body. The waves penetrate your skin and stimulate the muscles, tendons, and bones under the skin. This stimulation triggers the body's natural healing mechanisms, which can alleviate pain and inflammation, promote tissue regeneration, and improve blood circulation.

What Conditions Can ESWT Treat?

ESWT can be used to treat a variety of musculoskeletal conditions, including:

  • Achilles tendinopathy
  • Patellar tendinopathy (Jumper's knee)
  • Hamstring tendinopathy
  • Trochanteric pain syndrome (gluteus medius and minimus tendinopathy)
  • Plantar fasciitis
  • Rotator cuff tendonitis
  • Calcific tendonitis
  • Tennis elbow (lateral epicondylitis of the elbow)
  • Non-union and delayed union of long bone fractures

ESWT is also being investigated for other non-musculoskeletal conditions like treating erectile dysfunction, and cellulite. I would recommend that you discuss your unique needs with your healthcare provider to determine if ESWT is right for you.

What to expect when you have ECSWT

ESWT is usually performed on an outpatient basis, meaning you go home after the procedure. During the procedure:

A water-based gel is applied to the area being treated to help the shockwaves transmit into the body. A hand-held device is used to deliver the shockwaves to the target area. This can be noisy depending on which of the two types of shockwave devices available is been used. 

The first treatment is usually started at a low intensity building up to the point you are uncomfortable, verging on being painful.

Treatments typically take 15-20 minutes per session. You may require multiple sessions depending on the condition being treated.

What To Expect After ESWT Procedure?

After ECSWT, you can expect some discomfort or soreness around the site of treatment. Most people find that their pain improves over the course of the week. 

You can take paracetamol for pain, but you should NOT take non-steroidal anti-inflammatory medicines (NSAIDs) like ibuprofen as this may counter the effect of the shockwave treatment.

You can begin physical therapy whilst undergoing the treatment but I'd recommend reducing your levels of physical activity for 1-2 weeks after the course of treatment. If you're not sure what you should do speak to your physical therapist or doctor.

It is important to realise that there is no guarantee that ESWT will give you immediate results; the response to a course of treatment can take several weeks to show so you should continue doing your prescribed exercise programme.

Are There Any Risks or Side Effects?

ESWT is a generally safe procedure. However, like any medical procedure, there are risks and side effects. Potential risks and side effects of ESWT include:

  • Soreness, redness, or bruising around the treated area - tell your doctor if you have a tendency to bruise or if you are on blood-thinning medication before the procedure.
  • Swelling
  • Temporary pain in the treated area - you can take painkillers but avoid anti-inflammatories.
  • Numbness or tingling in the treated area. If this lasts beyond a couple of contact your doctor.
  • More serious complications, like a tendon or fascia rupture though extremely rare, may still occur.

It is essential to discuss all the potential risks and benefits of ESWT with your healthcare provider before undergoing treatment.

Is ESWT Covered By Insurance?

Most health plans cover ECSWT; your plan will likely pay for three to five sessions in a year. Ask your provider about any restrictions before scheduling your first session.


Extracorporeal shockwave treatment is a safe, non-invasive, and effective medical procedure that can treat a variety of musculoskeletal conditions. If you suffer from any of the conditions mentioned above, it may be worth discussing ESWT with your healthcare provider to see if it is a viable treatment option for you. Contact us and let us together determine the best course of action for your specific needs.

If you want to find out more about extracorporeal shock wave therapy (ECSWT) click here to go to the device patient information page.

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