Persistent musculoskeletal pain can be frustrating, particularly when it begins to affect walking, exercise, work or sleep. You may have tried changing your activity, following exercises or using other treatments, yet still feel that progress has stalled.
Shockwave therapy is one treatment that may be considered for some ongoing musculoskeletal problems. It is not a universal solution, and it is not appropriate for every type of pain. The most important question is not simply whether shockwave therapy is available, but whether it fits your symptoms, diagnosis and wider rehabilitation plan.
What is shockwave therapy?
Shockwave therapy, also called extracorporeal shockwave therapy, uses carefully controlled pressure waves applied to a specific area of the body. The treatment is delivered through a handheld applicator placed against the skin.
Although the name can sound intimidating, the treatment is delivered externally and does not involve surgery or injections. The pressure waves are directed at the painful or affected area, with the intensity adjusted according to the body region, your symptoms and your response during treatment.
Shockwave therapy has gained a strong reputation as a treatment option for certain chronic musculoskeletal pain and tissue problems. However, the fact that it is a modern treatment does not mean it should replace a proper assessment. Understanding what is causing your symptoms remains an important first step.
Who might benefit from shockwave therapy?
Shockwave therapy may be considered when pain has persisted, particularly where a tendon or other musculoskeletal tissue has not responded as expected to an appropriate rehabilitation programme.
Examples may include some forms of:
- Achilles tendinopathy
- Plantar fascia-related heel pain
- Tennis elbow
- Persistent tendon pain around other areas of the body
- Selected chronic musculoskeletal injuries
These examples do not mean that everyone with one of these conditions will benefit. Similar symptoms can have different causes, and pain in the same area does not always come from the same tissue.
For example, pain around the heel may relate to the plantar fascia, the Achilles tendon, the joints in the foot or ankle, or the way the lower limb is being loaded. Pain around the elbow may be influenced by work, gripping, sporting activity, neck symptoms or sensitivity in the local tendon. A treatment that is useful for one presentation may be less appropriate for another.
Why does assessment matter first?
A physiotherapy assessment helps establish what may be contributing to your pain and how it is affecting your movement and daily life. Your physiotherapist may ask about:
- When the pain started and whether it has changed
- Activities that increase or ease your symptoms
- Previous treatment and rehabilitation
- Your work, exercise and sporting demands
- Relevant medical history
- Your goals and what you would like to return to doing
A physical assessment may then look at movement, strength, flexibility, balance and the way the affected area responds to load.
This process helps determine whether shockwave therapy is a reasonable option. It may also identify an alternative explanation for your pain or show that another approach would be more suitable. In some situations, further investigation may be considered, but imaging is not automatically needed before treatment.
A clear diagnosis or working clinical explanation also makes it easier to measure progress. The aim is not simply to deliver a treatment, but to understand whether your pain, function and confidence are changing over time.
What happens during treatment?
If shockwave therapy is considered appropriate, you will be positioned comfortably so that the area can be accessed. Usually the applicator is applied to dry skin over the relevant area. For highly sensitive areas a silicone covering and oil can be used.
You may feel a rapid pulsing or pressure-like sensation. Some areas can feel more sensitive than others, especially when symptoms are already irritable. The intensity can usually be adjusted during the session, and your physiotherapist should explain what to expect and check how you are managing.
Treatment is generally brief, but the overall appointment may also include discussion, reassessment and exercise planning. The treatment itself is only one part of the appointment and should sit within a wider clinical approach.
It is common for the area to feel temporarily tender or sensitive afterwards. Your physiotherapist will provide individual advice about activity and what to do after the session. If you are unsure whether a response is expected, contact the clinic for guidance.
What should you expect from a course of shockwave therapy?
Shockwave therapy is not usually presented as an instant fix. Some people notice a change in their symptoms relatively quickly, while others need more time to assess whether the treatment is helping. Responses vary according to the condition, how long symptoms have been present, general health, activity levels and the rehabilitation plan being followed.
A course of treatment typically ranges between 3-5 sessions, although the exact plan depends on your assessment. It is important not to judge the treatment only by how the area feels immediately afterwards. Longer-term progress may be better reflected by changes such as:
- Walking for longer
- Managing stairs more comfortably
- Tolerating work or household tasks
- Returning gradually to running or sport
- Completing strengthening exercises with greater confidence
- Experiencing fewer or less disruptive symptoms
Your practitioner will track your progress with measurable outcomes to determine if treatment is effective. If there is no meaningful improvement, the treatment plan may need to be changed or the original diagnosis reconsidered.
Why are exercises still important?
A common misconception is that shockwave therapy can repair a problem without any active rehabilitation. In practice, exercises and sensible activity planning are often central to improving strength, capacity and confidence.
For tendon-related pain, the body may need a gradual return to the loads required for everyday life, work or sport. Exercises can help you build that tolerance in a measured way. Your physiotherapist may also advise on modifying activity, spacing out demanding sessions and progressing gradually.
Shockwave therapy may be used to support this process, particularly when pain is making rehabilitation difficult. Progress usually depends on finding a manageable balance between giving the body enough stimulus to adapt and avoiding repeated overload.
This is also why treatment plans can differ between people with apparently similar problems. A recreational walker, a manual worker and a competitive runner may need different advice even if they all have pain in the Achilles tendon.
Is shockwave therapy suitable for everyone?
No. Shockwave therapy is not automatically suitable for every person, condition or body area. Your physiotherapist will need to consider your symptoms, medical history, the tissue involved and any factors that could affect treatment.
It is important to tell your clinician about relevant health conditions, medication, recent procedures and any significant change in your symptoms. If your presentation does not fit the treatment, you should be offered appropriate advice about other options.
You should also seek an assessment if pain is severe, rapidly worsening, associated with significant weakness or numbness, or stopping you from using the affected limb normally. General information cannot determine the cause of an individual person’s pain.
Could shockwave therapy be right for you?
Shockwave therapy may be worth discussing if you have persistent musculoskeletal pain and progress has stalled despite sensible management. It may be particularly relevant when a tendon-related problem has been assessed and a structured rehabilitation plan is already being considered.
The best next step is an individual assessment. This gives you the opportunity to understand what may be causing your symptoms, whether shockwave therapy is appropriate, what alternatives may be available and how treatment would fit with exercise and activity.
At Great Northern Physiotherapy, shockwave therapy is provided as part of a broader assessment and rehabilitation approach. The goal is to help you understand your problem and make practical progress towards the activities that matter to you.
You may feel tapping, pressure or sensitivity during treatment. The intensity can be adjusted to help keep the experience manageable. The area may also feel temporarily tender afterwards.
The number of sessions depends on your symptoms, assessment findings and response to treatment. Your physiotherapist should review your progress rather than assuming that the same course is right for everyone.
This depends on the area treated, your symptoms and the type of exercise. You will be given individual advice about activity after each appointment. Shockwave therapy should not be followed by a sudden increase in training or loading.
No. It may be used alongside rehabilitation, but exercises and sensible activity progression are often important for rebuilding strength and tolerance.
An assessment is important to determine whether shockwave therapy is suitable and whether your symptoms are likely to respond to it. Your physiotherapist can then recommend an appropriate plan.
Book an appointment
If you have persistent musculoskeletal pain and would like to discuss whether shockwave therapy may be appropriate, book an appointment with Great Northern Physiotherapy. An assessment can help you understand your options and create a treatment plan suited to your goals.
Book an appointment or email info@greatnorthernphysiotherapy.co.uk.