Patient Information/ ESWT Technologies

Shock wave therapy – also known as extracorporeal shock wave therapy (ESWT), Extracorporeal Pulse Activation Technology (EPAT), Radial Pressure Pulse Therapy (RPPT) and acoustic wave therapy (AWT) among other names – uses acoustic waves to transmit peak pressure waves to promote and accelerate healing for subacute and chronic conditions.

• Remodel fibrotic tissue, release trigger points
• Reverse chronic inflammation
• Increase nitric oxide (NO)
• Activate stem cells and growth factors
• Reduce pain faster
• Improve range of motion
• Increase blood flow, microcirculation
• Stimulate tissue remodeling, neovascularization

Mayo Clinic – The evolving use of extracorporeal shock wave therapy (ESWT) in managing musculoskeletal and neurological diagnoses

What is extracorporeal shock wave therapy ESWT?

“Extracorporeal” means “outside the body.”  Shock waves are created by strong acoustic (sound) energy pulses.  

Our systems are a shock wave generator, very similar to the shock wave devices used to treat kidney stones without surgery.  The shock head or shockwave “gun” allows the shocks to reach to a patient’s body when the patient is in a sitting or lying position.

An example of the Siemens Sonocur ESWT device (new systems are smaller typically handheld devices)

Sonocur Device


An example of the Miracle Wave and AWT ESWT device 

Trained medical professionals will operate the system.  They will focus shock waves by moving the shock wave gun and by adjusting shock waves to go deep enough to give you the best treatment.

Who should consider having ESWT?

ESWT is for patients who have had pain for at least 6 months and who have tried other methods for treating their pain. 

What else should I know about the ESWT treatment?

You must stop taking NSAIDs (non-steroidal anti-inflammatory drugs such as aspirin) a week before you have ESWT to allow time for this medicine to completely pass through and out of your body.  You should do this because these medications may cause problems with blood clotting.  If this happens, bruising is more likely to occur.

The safety and effectiveness of the treatment has not been established for:

  • Pregnant women
  • Patients under 18 years of age
  • Patients with coagulation abnormality, thrombopathy, infection or tumor
  • Patients who have had previous surgery on treated area
  • Patients who suffer from severe systemic diseases that may lead to sensory changes or nerve-related pain.  For example, this may include diseases such as gout, diabetes mellitus, and rheumatoid arthritis.
  • Patients with cardiac pacemaker
  • Patients who received a local steroid injection less than six (6) weeks prior to ESWT

Your doctor can provide you with additional information about these and other conditions, and how they might affect the decision to have ESWT.

What adverse effects could happen with ESWT treatment?

The following effects were observed during the clinical trials:

  • Pain during and immediately after treatment was most commonly reported
  • Nausea was the second most commonly reported side effect
  • ESWT may cause sweating, dizziness, tremor, paleness and may temporarily widen blood vessels.  Most reported events were mild in severity and resolved within 24 hours without any further treatment.
  • ESWT may cause skin reddening or bruising of the treated area, which usually clears with a few days after the treatment.
  • ESWT may cause muscle pain (myalgia) and muscle tension (hypertonia).  Most reported side effects were mild in severity and resolved within 48 hours of treatment, without any further treatment.
  • ESWT may cause joint stiffness.  This side effect disappeared within 48 hours of treatment without any further treatment.
  • Some patients reported numbness and tingling sensations.  Most of these sensations resolved without treatment.

Potential adverse events not seen during the study include:

  • Neuropathy (problems with the nervous system)
  • Tendon rupture
  • Local hematoma (bruising)
  • Misdirection of energy

What happens during the treatment?

If your doctor recommends treatment, he/ she will feel the painful area in order to locate the exact point of tenderness.  This point may be marked on your skin with a color marker.  You will be treated sitting in a chair or lying down. Prior to the treatment, the operator will apply a coupling gel to the treatment area.  This gel makes it possible for the shock waves to enter the treated area.  Next, the shock wave gun is applied to the treatment area (the marked spot).  The treatment will be started with very low intensity pulses.  You may experience some irritation every time you hear the “clapping sound” produced by the system’s “loud speaker.”  The irritation that you feel should be in the area being treated.  If this is not the case, you should move the treated area with the operator’s help until you feel the treatment in the area of your pain.

After about 100 pulses, you may experience some kind of local numbness and the operator will increase the energy to the treatment level.  This may cause more pain that should eventually wear off after a couple of hundred pulses.  If the pain is too uncomfortable, you should tell the operator so that the shockwave gun may be moved. A total of 2,000 pulses will be applied during a single treatment session.  One treatment session will take about 20 minutes and is performed as an outpatient procedure.  A complete therapy usually requires 3 treatment sessions with a week pause between sessions.

If you have additional questions about ESWT, please be sure to talk with your doctor.

Effective Shock Wave Therapy partners with the best doctors throughout the country to offer ESWT treatments.  These treatments are performed in offices.

Trained medical professionals that partner with Effective Shock Wave Therapy operate the ESWT systems by moving and focusing the shock wave head at the exact point of pain, and then adjusting the shock waves to go deep enough to give the patient the best treatment.

Please click here for a list of Effective Shock Wave Therapy partners in your area.