Shockwave Therapy
Extracorporeal shockwave therapy (ESWT) uses acoustic pressure waves applied through the skin to stimulate a healing response in chronic tendon and soft-tissue conditions where recovery has slowed or stalled.
Book an initial visitWhat is Shockwave Therapy?
Shockwave therapy is a non-invasive treatment that applies acoustic pressure waves through the skin to support healing in tendons, ligaments, and other soft tissue — especially in areas where the body's natural repair process has stalled. No needles are involved.
The acoustic waves are delivered through a handheld applicator placed on the skin. They help increase local blood flow and may stimulate remodeling in chronically irritated tissue and calcific tendon problems, supporting the body's healing response. Over time this can reduce pain, improve mobility, and support longer-term recovery in tissue that has become chronically irritated or degenerated.
Shockwave is also frequently used alongside regenerative procedures like PRP — the mechanical stimulus of acoustic waves can complement the biological signal of growth factors, supporting a more complete healing response.
Many patients complete a series of 4–6 sessions, depending on the condition, severity, and response. Sessions take 15–30 minutes in clinic and require no recovery time.
Who is a good candidate?
Shockwave tends to work best for people with chronic tendon or soft-tissue conditions — typically symptoms lasting more than 3 months — particularly when rest, physical therapy, or anti-inflammatory approaches have provided only partial or temporary relief.
- Pain that has persisted despite conservative care
- Tendon pain or calcifications confirmed on imaging
- Chronic plantar fasciitis, tennis elbow, or Achilles tendinopathy
- Desire to avoid cortisone injections or surgery
How It Works
Shockwave triggers the body's natural healing mechanisms through controlled acoustic stimulation.
Sound Waves Delivered
Acoustic pressure waves are directed at the injured area through a handheld applicator placed on the skin — no needles, no anesthesia.
Tissue Response
The waves increase local blood flow and may help stimulate remodeling in chronically irritated tissue and calcific tendon problems, supporting the body's natural repair process.
Healing Cascade
Growth factors are released and new blood vessels may begin to form in the treated area, which may stimulate a renewed healing response in tissue where recovery had stalled.
Remodeling Over Time
Damaged tissue is gradually remodeled over the weeks following treatment. Many patients complete a series of 4–6 sessions, depending on the condition, severity, and response.
Benefits of Shockwave Therapy
Completely non-invasive — no needles or incisions
No anesthesia or medication required
May stimulate natural healing and tissue regeneration
Sessions typically 15–30 minutes
No downtime — return to normal activities the same day
May be effective for chronic conditions that have not responded to other treatments
Conditions Treated
Shockwave is particularly suited for chronic tendon and soft tissue conditions, especially those that have not improved with rest or conventional conservative care. The strongest evidence is for plantar fasciitis, Achilles tendinopathy, lateral epicondylalgia (tennis elbow), and calcific tendinopathy.
Research
Research is strongest for some conditions and more preliminary for others. The studies below are included to help patients understand where evidence is more established and why proper diagnosis and patient selection matter. They are specific to radial extracorporeal shockwave therapy (rESWT) — the type used in this clinic.
ESWT for Tendinopathy: Meta-Analysis
Meta-analysis (Majidi et al., 2024) pooling trials across multiple tendinopathy conditions, finding significant reductions in pain with extracorporeal shockwave therapy.
Read on PubMedRadial ESWT for Chronic Plantar Fasciitis
Confirmatory randomized, placebo-controlled multicenter trial (Gerdesmeyer et al., Am J Sports Med, 2008) showing radial ESWT is safe and effective for chronic recalcitrant plantar fasciitis.
Read on PubMedESWT for Plantar Fasciopathy: Meta-Analysis
Systematic review and meta-analysis (Lippi et al., 2024) confirming the efficacy and tolerability of ESWT for plantar fasciopathy across a broad set of randomized trials.
Read on PubMedESWT vs Corticosteroid for Plantar Fasciitis
Comparative RCT (Cortés-Pérez et al., 2024) showing ESWT produces outcomes comparable or superior to corticosteroid injection for plantar fasciitis, with a more favorable long-term profile.
Read on PubMedRadial Shockwave for Tennis Elbow
Randomized controlled trial comparing radial ESWT with supervised exercise, showing improvements in pain, function, and grip strength in lateral epicondylitis.
Read on PubMedESWT for Lateral Epicondylitis: Systematic Review
Systematic review and meta-analysis (Yao et al., 2020) evaluating the evidence for ESWT in lateral epicondylitis and supporting its use as an effective conservative option.
Read on PubMedPositive Radial ESWT Trial for Tennis Elbow
Prospective randomized controlled trial (Spacca et al., 2005) demonstrating meaningful pain and function improvements with radial shockwave therapy in lateral epicondylitis.
Read on PubMedRadial ESWT vs Sham for Tennis Elbow
Sham-controlled RCT (Capan et al., 2016) comparing radial ESWT against placebo in lateral epicondylosis — an important study in the ongoing refinement of optimal ESWT protocols.
Read on PubMedRadial Shockwave vs Corticosteroid for GTPS
Landmark RCT (Rompe et al., Am J Sports Med, 2009) comparing home training, corticosteroid injection, and radial shockwave therapy for greater trochanteric pain syndrome — the flagship radial ESWT citation for this condition.
Read on PubMedESWT for GTPS: Meta-Analysis
Systematic review and meta-analysis (Rhim et al., 2024) evaluating ESWT across focused and radial modalities for greater trochanteric pain syndrome, supporting its role in the treatment pathway.
Read on PubMedRadial Shockwave for Calcific Shoulder Tendinitis
Single-blind randomized controlled trial comparing radial shockwave, ultrasound-guided needling, and combined treatment for calcific tendinitis of the shoulder.
Read on PubMedESWT for Chronic Achilles Tendinopathy
Review of the current evidence (Gerdesmeyer et al., Int J Surg, 2015) supporting extracorporeal shockwave therapy for chronic Achilles tendinopathy.
Read on PubMedShockwave Therapy (ESWT): Common Questions
What is shockwave therapy?
Shockwave therapy, or extracorporeal shockwave therapy (ESWT), is a non-invasive treatment that uses acoustic pressure waves delivered through the skin to areas of chronic tendon and soft-tissue pain. The waves stimulate blood flow and the body’s natural repair process, with no injections, anesthesia, or surgery required.
What conditions does shockwave therapy treat?
ESWT is commonly used for plantar fasciitis, tennis elbow, calcific tendinitis of the shoulder, Achilles tendinopathy, and greater trochanteric (hip) pain syndrome, particularly when symptoms are chronic and have not responded to other conservative care.
Does shockwave therapy hurt?
Patients may feel a tapping or pulsing sensation and some discomfort during treatment, which is usually well tolerated and can be adjusted. No anesthesia is needed, and most people return to their normal activities right after a session.
How many shockwave sessions will I need?
Shockwave therapy is usually delivered as a short series of weekly sessions, but the exact number depends on the condition and your response. Dr. Borys recommends a personalized plan during your consultation — call (360) 738-3230 to learn more.
Is there any downtime after shockwave therapy?
There is generally little to no downtime. Some patients notice mild soreness in the treated area for a day or two afterward, which is a normal part of the healing response.
Ready to explore shockwave therapy?
It starts with an initial visit to discuss whether shockwave therapy is right for your condition — a standard medical evaluation that is typically billable to insurance, including plans such as Regence and Premera.