Back to Blog
November 24, 2024
10 min read
M.O. Therapy Team
Treatment Techniques

Shockwave Therapy: How It Works

Learn how shockwave therapy treats chronic pain and tendon problems. Complete guide to ESWT treatment, benefits, and what to expect.

shockwave therapyESWTtendinopathychronic painregenerative therapy

Shockwave therapy has emerged as a powerful treatment option for chronic musculoskeletal conditions that haven't responded to traditional treatments. This non-invasive therapy uses acoustic waves to stimulate healing and reduce pain. At M.O. Therapy in Markham, we utilize shockwave therapy as part of our comprehensive treatment approach.

What Is Shockwave Therapy?

Definition

Extracorporeal Shockwave Therapy (ESWT) delivers acoustic pressure waves to targeted tissue, stimulating the body's natural healing response without surgery or medication.

Types of Shockwave

Radial Shockwave (RSWT):

  • Most common type
  • Waves spread radially
  • Superficial tissue treatment
  • Commonly available
  • Lower energy

Focused Shockwave (FSWT):

  • Waves converge at focal point
  • Deeper tissue penetration
  • More intense
  • Specialized equipment
  • Higher energy

How It Works

Mechanisms:

  • Mechanical pressure waves enter tissue
  • Stimulates cellular response
  • Increases blood flow
  • Promotes tissue regeneration
  • Reduces pain signaling
  • Breaks down calcifications

The Science Behind Shockwave

Tissue Effects

Biological Responses:

  • Neovascularization (new blood vessel formation)
  • Increased growth factors
  • Collagen production stimulation
  • Stem cell activation
  • Inflammation modulation

Pain Relief

How Pain Decreases:

  • Disrupts pain receptors
  • Releases substance P (then depletion)
  • Gate control mechanism
  • Neurological effects
  • Cumulative benefits

Healing Promotion

Regenerative Effects:

  • Kick-starts stalled healing
  • Breaks chronic pain cycle
  • Stimulates tissue repair
  • Remodels damaged tissue

Conditions Treated

Highly Effective For

Tendinopathies:

  • Plantar fasciitis (heel pain)
  • Achilles tendinopathy
  • Patellar tendinopathy (jumper's knee)
  • Tennis elbow (lateral epicondylitis)
  • Golfer's elbow (medial epicondylitis)
  • Rotator cuff tendinopathy
  • Hip tendinopathy (gluteal)

Calcific Conditions:

  • Calcific tendinitis of shoulder
  • Heel spurs
  • Other calcifications

May Help

Other Conditions:

  • Chronic muscle pain
  • Trigger points
  • Stress fractures (off-label)
  • Bone healing (specialized use)

What to Expect

Before Treatment

Preparation:

  • Consultation and assessment
  • Diagnosis confirmation
  • Discussion of expectations
  • Review of contraindications
  • Treatment plan established

During Treatment

The Session:

  1. Area identified and marked
  2. Gel applied to skin
  3. Applicator placed on area
  4. Pulses delivered (2000-4000 typically)
  5. Duration: 5-15 minutes per area

Sensations:

  • Rapid tapping/pulsing feeling
  • Can be uncomfortable
  • Intensity adjusted to tolerance
  • Discomfort brief
  • Communication important

After Treatment

Post-Treatment:

  • May have temporary redness
  • Possible soreness 24-48 hours
  • Ice if needed
  • Normal activities usually fine
  • Avoid anti-inflammatories (may reduce effect)

Treatment Protocol

Typical Course

Standard Protocol:

  • 3-6 sessions
  • 1-2 weeks apart
  • Effects build over time
  • Full benefits may take weeks to months

Response Timeline

What to Expect:

  • Some immediate pain relief possible
  • Full effects develop over 12 weeks
  • Improvement continues after treatment ends
  • Some conditions respond faster than others

Success Rates

Research Shows:

  • 70-80% success for plantar fasciitis
  • 65-80% for tennis elbow
  • Variable for other conditions
  • Best when combined with exercise

Who Should Avoid Shockwave

Contraindications

Absolute:

  • Over malignancy/tumors
  • Over infections
  • Over growth plates (children)
  • Pregnancy (in treated area)
  • Blood clotting disorders
  • Over major nerves/blood vessels

Relative:

  • Blood thinners
  • Pacemakers (nearby)
  • Acute inflammation
  • Cortisone injection (recent)

Shockwave vs. Other Treatments

Shockwave vs. Injection

Shockwave:

  • No needles
  • Non-invasive
  • Stimulates healing
  • Multiple sessions needed
  • Cumulative effects

Injection:

  • Invasive procedure
  • Quick relief possible
  • Doesn't address cause
  • May weaken tissue (steroids)
  • Limited number recommended

Shockwave vs. Surgery

Shockwave:

  • Non-invasive
  • No anesthesia
  • No recovery time
  • Lower risk
  • Try before surgery

Surgery:

  • Invasive
  • Anesthesia required
  • Significant recovery
  • Higher risk
  • Usually last resort

Evidence and Research

What Studies Show

Strong Evidence For:

  • Plantar fasciitis
  • Calcific shoulder tendinitis
  • Lateral epicondylitis

Moderate Evidence For:

  • Achilles tendinopathy
  • Patellar tendinopathy
  • Greater trochanteric pain

Best Outcomes

Success Factors:

  • Correct diagnosis
  • Appropriate condition selection
  • Combined with exercise program
  • Patient compliance
  • Adequate treatment course

Combining Treatments

Best Results With

Complementary Approaches:

  • Exercise therapy (essential)
  • Manual therapy
  • Load management
  • Lifestyle modifications

Why Exercise Matters

Critical Addition:

  • Shockwave stimulates healing
  • Exercise provides appropriate load
  • Combined effect superior
  • Progressive loading important

Cost Considerations

Insurance Coverage

Varies By:

  • Insurance provider
  • Specific plan
  • Province/territory
  • Diagnosis

Investment

Consider:

  • May reduce need for surgery
  • Fewer ongoing treatments
  • Return to activity value
  • Cost-effectiveness

Shockwave at M.O. Therapy

Our Approach

Comprehensive Care:

  • Proper assessment
  • Combined with exercise
  • Individualized protocols
  • Progress monitoring

Equipment

Modern Technology:

  • Quality shockwave equipment
  • Evidence-based protocols
  • Trained practitioners
  • Safe application

Integration

Part of Treatment Plan:

  • Not standalone treatment
  • Combined with physio
  • Exercise prescription
  • Holistic approach

Frequently Asked Questions

How painful is shockwave therapy? Shockwave can be uncomfortable but is tolerable for most patients. Intensity is adjusted to your comfort level. Any discomfort is brief during the treatment session.

How many treatments will I need? Typically 3-6 sessions spaced 1-2 weeks apart. Some conditions may require more or fewer treatments based on response.

When will I feel better? Some patients notice immediate improvement, but full benefits typically develop over 12 weeks as tissue remodels. Patience is important.

Can I exercise after shockwave? Usually yes, though you may want to avoid intense activity on the treated area for 24-48 hours. Your practitioner will provide specific guidance.

Why should I avoid anti-inflammatories? Shockwave works partly through inflammation signaling. Anti-inflammatory medications may reduce this effect. Discuss medication use with your practitioner.

Is Shockwave Right for You?

If you have a chronic tendon problem that hasn't responded to other treatments, shockwave therapy may help. Contact M.O. Therapy in Markham for an assessment.

Contact Us:

  • Call (905) 201-5827
  • Book online
  • Direct billing available

Discover if shockwave therapy can help you return to pain-free activity.

Have Questions About This Topic?

Our experts are here to help with personalized advice.

Share This Post

Need Expert Care?

Don't wait for your symptoms to worsen. Get professional treatment today.

Related Articles

Treatment Techniques
Treatment Techniques

Manual Therapy Techniques Explained

Understand manual therapy including joint mobilization, manipulation, and soft tissue techniques. Learn how hands-on treatment can help your pain.

11/23/202411 min read