What Is Shockwave Therapy?
Shockwave therapy, also called extracorporeal shockwave therapy, is a non-invasive treatment that uses soundwaves to treat certain types of chronic injuries by reducing pain and promoting tissue healing by stimulating your body’s repair process.
How Shockwave Therapy Works
Shockwave therapy is administered through a handheld device over the skin.
The focused mechanical forces created by each of the soundwave pulses emitted by the device helps pain and healing in a few ways. It relieves pain by overstimulating sensory nerves or decreasing pain-signaling chemicals. It helps encourage healing by increasing blood flow and reducing inflammation, as well as stimulating your body’s repair cells, including fibroblasts, which are cells that help create collagen to heal connective tissues, and stem cells for regeneration (Ryskalin et al., 2025). They also stimulate osteoblasts, which are involved in bone healing and the production of new bone.
While shockwave therapy is used widely and works well for many people, more research is needed to learn exactly how it helps the body heal and which conditions and injuries it works best for.
It’s often used alongside other treatments and lifestyle changes that improve your systemic health for a better response to treatment.
Who Shockwave Therapy Helps
Shockwave therapy can help people with chronic tendon, muscle, joint, and bone injuries that haven’t improved with traditional treatments. It provides a nonsurgical option to treat stubborn injuries. By stimulating your body’s own healing capabilities, it may help avoid the need for repeated, long-term treatments, such as steroid injections or medication.
Your tissue’s ability to heal depends on your overall health. Many of the same lifestyle modifications that surgeons recommend patients make to improve surgical outcomes are also important for improving your response to shockwave therapy. These are modifications that help improve metabolic health, reduce chronic inflammation, and stimulate collagen production, such as not smoking, getting enough quality sleep, and eating a diet rich in protein, vitamin C, and zinc. Exercise, improving sleep, and getting to and maintaining a healthy weight are also important.
Shockwave therapy is best for people who are in good overall health or willing to make healthy changes to support their overall recovery.
Common Uses
Shockwave therapy is mostly used to treat musculoskeletal conditions, such as:
Achilles tendinopathy
Frozen shoulder
Tennis elbow
Golfer’s elbow
Heel bursitis
Jumper’s knee
Trigger finger
Mild to moderate carpal tunnel syndrome
Shin splints
Stress fractures and non-healing fractures
Knee osteoarthritis
While these are currently some of the more common uses of shockwave therapy, some experts are also using it to treat other conditions. For example, other types of osteoarthritis outside of the knee, lymphedema, and erectile dysfunction.
What the Evidence Supports
Shockwave therapy is widely used and accepted as a safe and effective treatment for tendinopathies, including tennis elbow.
A 2024 review of 18 studies found that compared to placebo, high-energy shockwave therapy effectively improved pain and function in people with upper limb tendonitis, including tennis elbow, as well as rotator cuff tendonitis and trigger finger (Xiong et al., 2024).
In a 2023 randomized controlled trial involving 87 patients who had tennis elbow that compared focused and radial shock wave treatments to a sham treatment, both shock wave groups showed significant improvements in pain and function scores with better results than the sham group (Kaplan et al., 2023). Another study a year earlier that compared shock wave therapy (ESWT) with other treatments for tennis elbow found that 5 sessions of ESWT led to greater improvements in pain, arm function, and grip strength than conventional physiotherapy (Aldajah et al., 2022).
Though research is ongoing, shockwave therapy is also emerging as a treatment for knee osteoarthritis thanks to some promising research. For instance, a 2024 review of 24 articles found that shockwave therapy was effective for knee osteoarthritis and in some cases was better than other therapies, including corticosteroid injections and physiotherapy. Adding shockwave therapy to isokinetic muscular strengthening exercises (IMSE) was also found to be better than IMSE alone (Liao et al., 2024).
Shockwave therapy has become a go-to for the treatment of sports-related injuries because it requires minimal downtime so you can get back to your training or activities while your body heals.
A 2024 review involving 56 studies and 1,874 athletes or physically active people found shockwave treatment to be safe and effective on its own for sports-related injuries, such as plantar fasciitis, tennis elbow, and proximal hamstring tendinopathy, and alongside exercise therapy for shin splints and osteitis pubis, which is inflammation of the joint between your pubic bones (Rhim et al., 2024).
Low intensity shockwave therapy (Li-ESWT) is a newer treatment for erectile dysfunction, and while more research is needed on long-term outcomes, recent studies are promising. One example is a 2023 systematic review of 52 studies which found that low-intensity shockwave therapy improves sexual function and erection hardness, suggesting it may be a safe and effective option (Bocchino et al., 2023).
Where the Evidence Is Limited
While widely used for treating numerous conditions – primarily musculoskeletal – more research is needed to understand exactly how shockwave therapy works. Research for some uses has shown mixed results and even those that have been more extensively researched still require more clinical evidence to determine the best uses and treatment protocols, and long-term safety and efficacy.
Safety and Regulation
Shockwave therapy devices are FDA-regulated medical devices, meaning they have been extensively researched for safety and efficacy. The FDA has approved shockwave therapy for certain conditions, such as plantar fasciitis and tennis elbow, but some emerging uses are considered “off-label” or experimental.
Like any medical treatment, shockwave therapy, despite being generally effective and well-tolerated, does carry the risk of side effects and complications. Local side effects, which are usually mild, can include pain, redness, swelling, and bruising.
Complications, though rare, include nerve irritation and damage. There have also been two reports of Achilles rupture (Tenforde et al., 2022).
Shockwave therapy isn’t recommended for everyone and should be avoided in patients who are pregnant, have an active infection, or those diagnosed with a bleeding disorder.
Choosing a qualified provider significantly reduces the risk of complications.
The Experience
Shockwave therapy is performed by a qualified physician after a consultation that includes a physical examination of the affected area and a detailed conversation about your medical history.
Your doctor will order imaging to get a better understanding of your injury. Shockwave therapy typically requires 3 to 5 sessions spaced one week apart (Tenforde et al., 2022).
Though shockwave therapy may sound painful, research shows that it’s typically well tolerated and safe when performed by a qualified physician.
The Future of Shockwave Therapy
Shockwave therapy continues to evolve at a fast pace with new devices and innovations in technology, and more robust research exploring its potential benefits for a wider range of conditions.
Takeaway
Shockwave therapy offers a promising noninvasive option for those seeking relief from chronic musculoskeletal conditions and sports injuries. Combined with healthy lifestyle modifications, shockwave therapy may help you get the long-term relief you’re after.
