What Is Extracorporeal Shock Wave Therapy?

Shock wave therapy is a non-invasive method that uses pressure waves to treat various musculoskeletal conditions. High-energy acoustic waves (shock waves) deliver a mechanical force to the body’s tissues.


Shock wave therapy may treat conditions such as degenerated tendons (Achilles tendinitis), heel pain (plantar fasciitis), and tennis elbow (lateral epicondylitis).

Complications are rare with shock wave therapy. People who have poor sensation (neuropathy) or hypersensitivity in the target area should not have this procedure. Open sores also are a reason to avoid shock wave therapy. Shock wave therapy is not used in patients with heart conditions or seizures. It should not be used during pregnancy. You should discuss any potential risks with your foot and ankle orthopaedic surgeon before undergoing the procedure.


A non-invasive probe is applied to the skin. An electrical charge creates an energy wave that is focused on the area of concern. The shock waves create a force on the tissues that may induce healing. It’s not clear why this approach to healing works for some people, but it may be that shock waves cause inflammation and improve blood flow to encourage the body to repair and heal itself.

Specific Technique

Shock wave therapy is an outpatient procedure. A probe is placed on the skin after a gel is applied to help conduct the shock waves. High- or low-energy waves may be used. High-energy waves may cause pain and require a local or regional anesthetic. Low-energy shock wave therapy often is performed without anesthesia. Therapy is more successful with active patient participation where the patient tells the therapist whether or not the probe is at the area of pain. One or more treatment sessions may be needed.


Patients typically bear weight after treatment. Patients are advised to reduce the level of physical activity for 1-2 weeks after treatment. Shock wave therapy may give good outcomes for some tendon problems or chronic degenerative conditions. Examples include Achilles tendinitis and plantar fasciitis.

Risks and Complications

The main complications are pain and hypersensitivity at the site of treatment. These problems typically resolve with time. Pain and disability may persist when shock wave therapy is not successful.


Is this a substitute for surgery?
Shock wave therapy is a non-invasive treatment that can help avoid surgery. Treatment responses may vary. Success cannot be guaranteed.

Is this covered by insurance?
This depends on the insurance policy. Discuss this with your surgeon and contact your insurance carrier before having the procedure. If your insurance does not cover it, you will need to pay out of pocket.


Original article by Sudheer Reddy, MD
Last reviewed by David Porter, MD, 2018

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