Extracorporeal Shockwave Therapy

Extracorporeal shockwave therapy (ESWT) offers an alternative to surgery without significant downtime.

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Quick Takeaways

  • Extracorporeal shockwave therapy (ESWT) uses high-intensity sound waves to stimulate blood flow and trigger your body’s natural healing response without surgery or medications.

  • ESWT is used primarily for chronic tendon and soft tissue conditions, including plantar fasciitis and Achilles tendinopathy. Providers also use it for calcific tendinopathy, stress fractures or fractures that haven't healed (nonunions).

  • Each treatment usually takes around 15 minutes, with treatments occurring at weekly intervals. Most patients can resume their usual activities without any downtime.

  • At UCLA Health, ESWT is part of a comprehensive treatment plan rather than a stand-alone therapy.

What Is Extracorporeal Shockwave Therapy?

Extracorporeal shockwave therapy is a noninvasive treatment that uses sound waves to reduce pain and help heal injured tissue.

A healthcare provider, such as a sports medicine specialist, places a hand-held device against your skin. The device sends sound waves through your skin into the injured area. These sound waves increase blood flow, break up painful calcium deposits and help repair damaged muscles and tendons.

Types of Extracorporeal Shockwave Therapy

There are two types of extracorporeal shockwave therapy:

  • Focused shockwave therapy: Delivers sound waves deep into the tissue in precise areas. Focused therapy is ideal for severe tendon conditions or bone-related pain. 
  • Radial shockwave therapy: Targets a broader surface area. Radial therapy is typically used for treating larger muscle groups.

What Conditions Does Extracorporeal Shockwave Therapy Treat?

ESWT can treat musculoskeletal conditions such as:

  • Achilles tendinopathy
  • Gluteal tendinopathy
  • Hamstring tendinopathy
  • Nonunion fractures
  • Patellar tendinopathy (jumper's knee)
  • Plantar fasciitis
  • Rotator cuff tendinopathy with and without calcium deposits
  • Stress fractures
  • Tennis elbow (lateral epicondylitis) and golfer's elbow

What to Expect

Your provider confirms your diagnosis with a clinical evaluation before starting ESWT. They may recommend X-rays or advanced imaging before treatment to assess the affected area and guide treatment planning.

The provider applies gel to your skin and moves the shockwave device slowly and continuously over the target area for about 15 minutes. While ESWT may be mildly uncomfortable, most patients handle it well. Your provider can adjust the treatment intensity based on your comfort level. A typical ESWT course consists of three to five treatments depending on your condition.

You may not notice improvement until at least six weeks after the last treatment, with peak effects taking up to 12 weeks.

You may experience mild side effects for a few days after each treatment, including redness, bruising or swelling. Patients can continue their normal daily activities and exercise during ESWT treatments without the need for downtime. 
 

Who Can Benefit from Extracorporeal Shockwave Therapy?

ESWT is generally considered for people with musculoskeletal pain that has persisted for three to six months and hasn't improved with other conservative treatments, such as activity modification, icing and physical therapy.

Who should not have extracorporeal shockwave therapy?

ESWT is not recommended for pregnant patients or those with:

  • Blood-clotting disorders
  • A pacemaker or defibrillator 
  • A malignant tumor in the shockwave field

Why Choose UCLA for Extracorporeal Shockwave Therapy?

When you choose UCLA Health for ESWT, you benefit from:

  • Trusted expertise: You receive treatment from a team of experts trained in ESWT and other nonsurgical treatments for chronic bone and soft tissue injuries. 
  • Comprehensive options: UCLA Health offers both focused and radial shockwave therapy, the two primary forms of ESWT. Access to both devices means we can individualize treatments based on your specific needs.
  • Innovative treatments: We offer other orthobiologic treatments that can be used along with ESWT, including platelet-rich plasma injections (PRP), to maximize healing and boost recovery. 
  • Specialized experience: Physicians at UCLA Health are experts in the use of ESWT in elite collegiate and professional athletes.
  • Evidence-based care: Our doctors use an evidence-based approach to patient care and actively conduct research investigating potential applications of ESWT and other orthobiologic treatments. As a patient at UCLA Health, you may have the opportunity to try promising new therapies and participate in clinical research studies.